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Integrating Clinical and Community Service Delivery

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This webinar will provide details and insights from an Area Agency on Aging’s (AAA) experience managing the CMS Innovation Center’s Accountable Health Communities (AHC) model. The Denver Regional Council of Governments is the only AAA in the country to manage an AHC, a model designed to 1) bridge the divide between clinical care providers and community service providers and 2) determine the financial improvements and quality health outcomes made by community organizations. The Project Director will share his perspective building and managing formal partnerships with clinical service providers, aligning organizational goals between community and clinic providers, and navigating the complex structure of health systems.

This webinar includes complementary ASWB CE credits.



AJ Diamantopoulos is the Accountable Health Communities Manager for the Denver Regional Council of Governments (DRCOG) Area Agency on Aging. AJ leads the team that works with clinical and community providers to demonstrate the critical link between better health outcomes and increased access to community-based services. Before joining DRCOG in 2013, AJ worked in various roles as a small business owner and then as an advocate for victims of domestic violence, followed by a role as a Service Coordinator with older adults for Volunteers of America and in Durango, Co. AJ holds a bachelor’s degree in humanities and a master’s degree in healthcare policy. 


Participants in this web seminar will be able to:

•    Discern the difference between social determinants of health and health-related social needs and adjust their strategy to match.
•    Identify the best strategy to identify and address a patient’s health-related social needs in a clinical setting.
•    Identify strategies to create successful partnerships with clinical delivery organizations.