Innovative partnerships among hospitals, public health departments, and community organizations are addressing root causes of local health problems, according to a new report from Advisory Board that outlines best practices from 18 communities that have begun forming effective coalitions under the BUILD Health Challenge.
By 2019, Medicare and Medicaid reforms will affect physician payments based on resource use and total costs of care, prompting hospitals and health systems to focus more strongly than ever on community health as a whole. According to research published in The New England Journal of Medicine, up to 80-90% of health status is attributable to factors other than clinical care. The vast majority of physicians cite socioeconomic conditions such as lower income or education, environmental hazards, and lack of access to healthy food, safe housing, and transportation as leading directly to poorer health outcomes, but only 20% of physicians are confident in their ability to address these problems, according to a study conducted on behalf of the Robert Wood Johnson Foundation.
Hospitals and health systems have struggled to build partnerships that would improve health outcomes and generate significant savings. The new report – Building the Business Case for Community Partnership: Lessons from the BUILD Health Challenge – identifies four critical steps to promote population health management and collaboration across the continuum of care: strongly engage hospital or health system leadership; prioritize initial focus on a subset of initiatives that will be iterated; strengthen partnerships to build on the skillsets, relationships, data, or tools each partner brings; and design seamless screening and referral protocols.
The BUILD initiative, cofounded by Advisory Board to promote partnerships that are Bold, Upstream, Integrated, Local, and Data-Driven, started with grants to 18 communities in 2015. This analysis of the 18 funded communities reinforced the belief that transforming health outcomes requires a carefully coordinated effort to eliminate silos.
The report found that engaging hospital or health system leadership helps garner the executive buy-in and secure the resources needed for success. Since many health care organizations have multiple initiatives occurring at once, the report suggests that hospital and health system leaders recognize that the process is an iterative one and begin by focusing on a few prioritized services.
The research also found that successful initiatives leveraged the unique strengths of community organizations to extend the reach of the health care team. The recommended final step – design seamless screening and referral protocols – helps health care providers ensure timely follow-through, which also improves patient and provider satisfaction.
Data demonstrate the need for such coordinated efforts to address “upstream” health factors. For example, while people are 2.9 times as likely to have poor overall health if they are members of a food-insecure household, evidence shows that programmatic approaches can help. Research from the Center for Effective Government showed that every $1 spent on Meals on Wheels produced $50 in Medicaid savings. Similarly, offering housing and supportive services to high-cost homeless individuals produces an annual per-person health care savings of $8,000, according to a study in Health Affairs.
BUILD Health Challenge Open for New Grant Applications
The BUILD Health Challenge will fund additional grants for at least 17 more communities in 2017. The Round 1 application period for funding closes on February 21. Interested hospitals and health systems can attend informational webinars on December 12 or 15 or January 31.