HSRProj will be retired on September 14, 2021, no updates will be made to HSRProj after this date.
Detailed information about this transition can be found on the
June 3, 2021 Technical Bulletin post.
If you have questions or suggestions, please contact
NLM Customer Service.
Information about ongoing health services research and public health projects
| Understanding the integration of medical care and social services under new payment models | |
|---|---|
| Investigator (PI): | Lewis, Valerie A |
| Performing Organization (PO): |
(Current): Dartmouth College, Dartmouth Institute for Health Policy and Clinical Practice / (603) 653-0800 |
| Supporting Agency (SA): | Agency for Healthcare Research and Quality (AHRQ) |
| Initial Year: | 2016 |
| Final Year: | 2018 |
| Record Source/Award ID: | RePorter/R03HS024792 |
| Funding: | 2016 Award Amount: $50,930 |
| Award Type: | Grant |
| Abstract: | Non-medical or social factors substantially affect individuals' health outcomes, quality of health care, and medical costs. Services addressing social needs are rarely integrated with routine medical care. Despite the impact of non-medical factors on the medical system, little is known about the best ways to address non-medical needs within the medical system. The Affordable Care Act is changing payment models for health care providers that are attempting to shift from paying for each service provided, which encourages high volume of services, to paying for the quality and efficiency of care, which encourages high value of care. Accountable care organizations (ACOs), the central payment reform in the Affordable Care Act, create groups of physicians collectively responsible for costs and quality of care for a population of patients. Current estimates suggest there are over 700 ACOs in the United States, including approximately 400 ACOs with Medicare contracts and 300 with commercial contracts; additionally, 18 states are pursuing or implementing ACO contracts within their Medicaid programs. Given the significant impact of non-medical factors on health outcomes and medical costs, health care providers under ACO contracts may address underlying non-medical factors as a way to control medical costs and improve quality. Previous research has highlighted the benefits of integrated health care services delivery, but the operational and financial considerations of integrated medical, non-medical, and social services are poorly understood. To understand how ACOs integrate social services within the ACO structure, we will conduct interviews with 20 ACOs. We will explore how ACOs initiate, adapt, modify, and sustain their approaches to addressing non-medical needs and integrating social services into medical care. The interviews will help us examine the motivations or constraints that may have influenced ACOs to adopt or change their approaches. This project leverages our team's considerable experience with qualitative research with ACO executives, as well as deep expertise on ACO models and specifically how ACO models work for disadvantaged patients. This project will provide important insight into how ACOs achieve greater integration of social services with clinical providers. Results will be of interest to policymakers, providers, and payers, and will help them implement ACO programs most efficiently. |
| MeSH Terms: |
|
| Country: | United States |
| State: | New Hampshire |
| Zip Code: | 03756 |
| UI: | 20171227 |
| Project Status: | Completed |
