Spring 2018 Generations

GENERATIONS – Journal of the American Society on Aging

The Community’s Emerging Role in Value-Based Health and Social Services By Margie Powers The role of community-based organizations is expanding as they partner with healthcare entities.

W ith the simultaneous movement in the healthcare industry toward value over vol- ume, and population-based health management, there is growing recognition that non-medical services are as important as those received in a provider’s office, especially for people with high needs, who engender high costs. Social determi- nants of health—economic stability; education and income status; access to healthcare, food, and housing; and environmentally safe communi- ties (Centers for Disease Control and Prevention, 2017)—are known to substantially determine negative or positive health outcomes, and have a disproportionate impact on health, compared to health behaviors and clinical care (Amarasing- ham, 2016). The combination of social, behavioral, and environmental factors contributes substantially to specifc health issues, including to more than 70 percent of some types of cancer, 80 percent of heart disease cases, and 90 percent of stroke

cases (Bradley et al., 2016). Healthcare organiza- tions are starting to more closely examine how to address social determinants’ impact on health, and one strategy is exploring closer partnerships with community-based organizations (CBO), ‘States with higher levels of spending on social services performed better on a list of health outcomes.’ establishing contracting relationships to support high-need, high-cost individuals. Traditionally, CBOs deliver services that aim to address the social needs of this population. While these services also can affect health, in most cases they are not directly reimbursed by plans or provider organizations. Given the cur- rent evolution of the healthcare industry, there is ample opportunity to develop cross-sector payment mechanisms to support high-need,

abstract Social determinants of health are known to impact health outcomes, and there is growing recognition that non-medical services are as important as those received in a provider’s office, espe- cially for high-need, high-cost populations. Healthcare organizations are exploring closer partnerships with community-based organizations (CBO), especially in support of this group. There is ample oppor- tunity to develop cross-sector payment mechanisms to support these individuals and to provide financial stability to valued community organizations. | key words: high-need, high-cost populations, CBOs, social determinants of health, Partners in Care

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