National Academy of Medicine Explores Integration of Social and Health Services

The National Academy of Medicine’s (NAM) Care Culture and Decision-Making Innovation Collaborative (CCDmIC) recently brought together leading experts to discuss an issue that is rapidly gaining traction as a powerful new direction in American health care: the integration of clinical and social services to meet the goals and needs of individuals coping with complex care needs.

The goal of CCDmIC, one of the four Innovation Collaboratives of the Leadership Consortium for a Value & Science-Driven Health System at NAM, is to “change the culture of health care to deliver on the vision of a system in which all stakeholders actively and effectively work together to make shared decisions informed both by the most up-to-date evidence and the needs and preferences of patients, families, and the community at large.” Drawing together a broad base of health care thought leaders, researchers, providers, health plans, government and private leadership, the meeting represented a recognition of the powerful forces of social and behavioral determinants of health and the crucial role of health self-management in person-centered care models.

The meeting began with a session featuring the Administration for Community Living (a funder of the Aging and Disability Business Institute), the Centers for Medicare & Medicaid Services, the National Governors Association and a family caregiver advocate. Speakers explored the environmental and contextual factors driving increasing efforts to integrate social and health services. The panel also spotlighted early pioneers in this evolving field demonstrating great variety in models being tested in diverse settings, such as the Colorado Permanente Medical Group, the Pacific Business Group on Health, AARP and the U.S. Department of Veterans Affairs.

June Simmons, President and CEO of Partners in Care Foundation (a key community-based organization and partner of the Aging and Disability Business Institute), spoke about the strong models of integration being built around the country using regional networks of community-based organizations (CBOs) that deliver home and community-based services, and are known and trusted experts on what happens at home.

Successful models for integrating human services into health care are emerging across the country between CBOs and health plans, provider groups, and hospitals. They are building better ways to identify social factors and resource needs that are essential to optimizing health outcomes.

CBOs are experts in addressing the social services needs of consumers that health care systems are in a position to identify. However, payment models that recognize and invest in social services have not yet materialized, presenting a significant barrier for expanding this critical work. This may begin to change under the new payment models. Unfortunately, some health care organizations are considering building this capacity in-house, rather than buying these services from CBOs that have decades of experience and success in providing this care.

NAM’s role has been crucial in bringing emerging issues to light and establishing forums and collaboratives with diverse expertise that can elevate evidence-based solutions for health care challenges. Now is the time for integrated solutions that address social and behavioral determinants of health, recognize the value that CBOs bring to delivery system reforms, and—most importantly—pay for that value. NAM’s leadership is to be commended, supported, and followed with great interest as this movement matures and unfolds in our care settings.