Medicare, Medicaid to test seamless social work

The Department of Health and Human Services hopes better integration of 44 agencies improves quality and affordability by helping non-medical aspects of people's lives.

By Stephen Feller

WASHINGTON, Jan. 5 (UPI) -- The Department of Health and Human Services announced a pilot program to link up to 44 bridge organizations to screen people for health-related social needs and link them with local community programs that can help.

The Accountable Health Communities Model is a five-year program run by the Centers for Medicare and Medicaid Services to screen program beneficiaries to help them get more value out of the healthcare programs.


CMS will be aiming at community-based organizations, hospitals, health systems, and local governments, among others, to develop a referral network and use a comprehensive screening program at participating clinical delivery sites.

Helping to improve social issues such as housing instability, hunger, or lack of transportation has a direct effect on health, officials at the agencies said, prompting the creation of the program.

"For decades, we've known that social needs profoundly affect health, and this model will help us understand which strategies work to help improve health and spend dollars more wisely," said Dr. Patrick Conway, CMS Deputy Administrator and Chief Medical Officer, in a press release. "We will learn how health and health care improvements can be achieved through strong partnerships and linkages at the community level."


Using $157 million, funded by the Affordable Care Act, the program will determine bridge organizations to oversee the screening of program beneficiaries for social and behavioral issues. The organizations will then connect them to or help them navigate services -- such as helping a patient who doesn't take medication because they can't get to the pharmacy or helping a person apply for the Low Income Energy Program.

Applications to participate in the program are due in early 2016, with awards announced in Fall 2016. As assessments are used and data gathered on the program's progress, the agency plans to organize an advisory board and data-sharing to generate improvement plans for the five-year program.

The aim, officials said, is to develop a model that positively impacts the cost of healthcare by improving its quality, which includes helping patients improve aspects of their lives that are not specifically medical.

"We recognize that keeping people healthy is about more than what happens inside a doctor's office, and that's why, for the first time, we are testing whether screening patients for health-related social needs and connecting them to local community resources like housing and transportation to the doctor will ultimately improve their health and reduce the cost to taxpayers," said HHS Secretary Sylvia Burwell.


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