Center for Health Care Strategies

This fact sheet outlines strategies to help Medicaid stakeholders encourage partnerships between community-based organizations and health care organizations. States can provide: (1) financial support to build and sustain program capacity; (2) assistance in identifying metrics for evaluation; (3) incentives to providers to address social determinants of health; and (4) use of policy levers, including value-based contracts, managed care organization regulations, and state plan amendments.

This tool was designed for community-based organizations and health care organizations in existing partnerships. It provides a template to understand progress toward benchmarks characteristic of effective partnerships, identify areas for further development, and guide strategic conversation. This tool is meant to help partnering organizations work together more effectively and maximize their impact.

The Eastern Virginia Care Transitions Partnership (EVCTP) is a largescale partnership including Bay Aging and four other Area Agencies on Aging (AAAs), four health systems, three managed care organizations (MCOs), and other health care and human service providers. This case study describes several topics including the service delivery model, information sharing and reporting, shared governance, success factors, and challenges.

The Partnership for Healthy Outcomes, a project of the Center for Health Care Strategies, Nonprofit Finance Fund, and the Alliance for Strong Families and Communities, has published a report that captures and analyzes lessons from health care organizations and community-based organizations (CBOs) that are partnering to address both the clinical and the social determinants of health. This report is based on a survey of more than 200 health care related partnerships.

This brief, a product of the Complex Care Innovation Lab made possible by Kaiser Permanente Community Benefit, outlines the current state of Medicaid NEMT services, its challenges, and opportunities for improvement. It explores alternative transportation models piloted by states and health plans across the country, including the use of transportation network companies, such as Uber and Lyft, to augment NEMT services.

The Center for Health Care Strategies, with funding from DentaQuest Foundation, published a technical assistance brief that provides a framework to improve social determinants that affect oral health in the community.

The Center for Health Care Strategies, Inc. released a technical assistance brief, funded through support by the Robert Wood Johnson Foundation, titled "State Medicaid Managed Long-Term Services and Supports Programs: Considerations for Contracting with Medicare Advantage Dual Eligible Special Needs Plans."

Many individuals with long-term services and supports (LTSS) needs either reside in institutions or are at risk for institutionalization. Rebalancing care to provide LTSS in the community is one goal of the federal Financial Alignment Initiative for Medicare-Medicaid enrollees. This profile details the experiences of the Health Plan of San Mateo (HPSM) as it implements a pilot program to help dually eligible individuals in nursing facilities transition back to community living.

The Center for Health Care Strategies released a brief, funded by the Commonwealth Fund, that examined member engagement approaches used by participating health plans in Promoting Integrated Direct Care for Eligibles (PRIDE). The brief highlights promising strategies for providing Medicare-Medicaid enrollees with complex medical, behavioral health, and social service needs. There is a specific emphasis on the approaches to building trusting relationships with members.