Impacting Quadruple Aim through Sustainable Clinical-Community Partnerships: Best Practice Models from a Community-Based Organization Perspective
Health reform initiatives have caused disruptive change throughout the U.S. Healthcare system. One of the key drivers of change is the adoption of alternative payment models that apply financial risk on physicians and hospital systems. In 2017, 34% of U.S. health care payments, representing approximately 226.3 million Americans and 77% of the covered population, flowed through alternative payment models built on fee-for-service architecture or population-based payment models. As the shift towards value-based payment continues to accelerate, success in these models requires health care providers, ACOs, and managed care organizations to continue developing population-based approaches. Successful population health management models require risk-stratification of the target population and linkage of the population to interventions and programs based on risk, as well as an increased understanding of the impact lifestyle choices, health-related social needs, and social determinants on health have on health outcomes.
Often, community-based organizations (CBOs) are positioned to serve as an extension of the care continuum because they provide desired access points to upstream services that address the non-clinical factors that impact approximately 80% of health outcomes. Despite the clear role of community-based organizations in addressing lifestyle change, many healthcare providers fail to enter into sustainable contracts with organizations in the community. The failure of the traditional healthcare market to embrace the role of community-based organizations to address social factors impacting health limits their ability to achieve improved Quadruple Aim measures.
YMCA of the USA, with funding from the Robert Wood Johnson Foundation, conducted a two-year project to provide technical assistance to local Ys that partner with healthcare providers to demonstrate best practices of medical-community partnerships to address the health of a target population. Based on their experience supporting partnership development throughout the country, YMCA of the USA’s Clinical Integration team will present best practice models of sustainable clinical-community partnerships that impact clinical cost and quality measures.
- Describe the role that partnerships with community-based organizations can play in achieving population health goals.
- List common challenges to establishing sustainable clinical-community partnerships.
- Apply concepts needed for entering into mutually beneficial and sustainable partnerships with community-based organizations.