In recent years, the impact of the social determinants of health on an individual’s health and well-being has moved to the forefront of attention for many in the health care sector. The Social determinants of health include the social, economic and environmental factors that take place outside of typical health care settings and include access to healthy foods, public safety, and safe and affordable housing.
Providers, health plans and others in the health care sector have come to recognize that a powerful way to address social determinants head-on is by supplementing their traditional, clinical services with those offered by aging and disability community-based organizations (CBOs). By definition, CBOs are embedded within the community, giving them an advantage that the health care sector wants to leverage: local knowledge and regular access to individuals in the environments in which they live. This gives both CBOs —and health care partners—the ability to identify potential health issues and connect individuals to vital community services and supports that can keep them healthy before costly health conditions develop.
As the health care sector grows increasingly receptive to partnerships with CBOs and opens the door for a closer integration, aging and disability community-based service providers need to likewise seize this opportunity to actively pursue these partnerships as a way to expand their own resources, capacity and ability to reach more individuals in need within their communities.
Sustainability Through Health Care Partnerships
Partnerships between CBOs and health care entities can take a variety of forms based on a community’s needs, partnership goals and available resources. One example from Meals on Wheels America is detailed in a recently released report, Effective Partnerships Between Community-Based Organizations and Health Care: A Possible Path to Sustainability,” which explores how we worked effectively with a health plan—and, in turn, how other CBOs can do the same—to sustainably scale services and address social determinants of health. Below are some of our lessons learned, guidance and recommendations on how CBOs can pursue partnerships of their own within the health care sector.
Five Ways to Open the Door for Health Care
To start a conversation with a potential health care partner and overcome initial barriers to entry, consider these steps for preparing your organization.:
- Know your environment. The health care space is complex and changing rapidly, making it a challenge to navigate well. To help you gain a stronger understanding of the intricacies of securing and managing a health care partnership, who has relevant experience in your target market (e.g., contracting with Medicare Advantage (MA) plans). There are a number of consultants helping CBOs connect to health plans—for example, we worked with Gorman Health Group. The Aging and Disability Business Institute (Business Institute) also has a consulting program consisting of nationally recognized consulting firms that can help CBOs in their health care contracting work. Turning to consultants for their expertise can help to identify viable partners and provide you with the technical assistance needed to understand relevant business needs, contracting requirements and timelines, etc.
Knowing your environment also includes knowing your organization’s own readiness to pursue these partnerships. The Business Institute’s online Readiness Assessment tool can help guide your organization through the process of successfully preparing for, securing and maintaining partnerships with the health care sector, allowing your organization to assess its current readiness, while also providing a framework and resources for navigating the process successfully.
- Articulate your value proposition. Once you understand the needs of your potential partners—what they are looking for in a CBO partner, how they operate, steps your organization may need to take to meet their requirements—figure out how to communicate your organization’s value proposition in language that will resonate with those partners. Find a way to translate what you do into how it supports quality of care, STAR ratings (a system created by the Centers for Medicare and Medicaid Services to rate the quality and performance of across several categories) and reducing health care cost. The more metrics you can share to measure direct outcomes and validate the return-on-investment (ROI) of the services your organization provides, the stronger you can make your value proposition and, in turn, your business case.
- Demonstrate data readiness. Ensure your organization has the infrastructure and systems in place to keep your clients’ data secure, and the ability to manage secure and consistent data requirements. This will be of the utmost importance to any potential health partners, regardless of size or structure. Start with HIPAA/HITECH compliance as a basis for evaluating data systems, then pursue a system that meets your needs without making the process too complex.
- Talk to the right person. In order to get your foot in the door, make sure you’re talking to the right person at a potential partner organization—often, this will be someone who works in population health. Making this connection may simply be a matter of leveraging a relationship with someone you already know who can help connect you, or you may need to do some cold outreach to relevant individuals within the organization. Once again, an outside advisor with experience in the field would be ideally suited to help you identify and secure a conversation with the correct individual(s).
- Increase your reach. Your organization may currently provide services to your local community. However, a health care entity may likely serve a larger geographic region and mays need a partner to cover their entre service area. If your organization alone does not have the reach or capacity to serve a health plan’s entire contract area, consider partnering with other CBOs that may be able to help strengthen your organization’s offerings, fill any existing service and geographic gaps and make contracting simpler for the health care partner.
The health care sector and community-based organizations are working together more frequently to address the social determinants of health to improve individuals’ quality of life and overall health while keeping costs down. Beginning your journey with the five steps outlined above will help put your organization on the right track toward building successful health care partnerships.
For more on this topic, listen to the Business Institute’s 2019 webinar, Building and Financing Sustainable Partnerships between Health Care and Community-Based Organizations.