Accountable Care Organizations (ACOs) bring together health care providers who take responsibility for delivering health care services while controlling costs and improving health outcomes for their patients. Today, nearly 560 Medicare ACOs serve more than 12.3 million beneficiaries and hundreds of Medicaid and commercial ACOs attend millions of other patients.
Increasingly, ACOs turn to Community Based Organizations (CBOs) – local nonprofit groups or organizations that work to improve life in their community – to help deliver on their cost and outcome goals. This collaboration makes sense because ACOs are assuming the financial risk of keeping their members healthy and many CBO services address key social factors – such as housing and food insecurity, behavioral health, job training — that affect health and drive the costs of health care for disadvantaged populations.
As health care payment moves from a fee-for-service model to accountable care, CBOs have an interest in being part of a larger system of health promotion. While CBOs are well-positioned to help address access issues and promote health equity, ACOs typically require evidence of service effectiveness before partnering. Unfortunately, the ability to collect information and translate the evidence of a service’s value to external parties is not available to every organization.
We recently partnered with a New York-based CBO when their management asked for assistance in framing and communicating the high value benefits their evidence-based family therapies bring to their ACO partners.
We began by digging into the latest information about the use and effectiveness of relevant evidence-based practices (EBPs) and engaging in conversations with staff and management to understand their process for selecting and developing EBPs to fit the needs of their specific patient populations. Based on our research and drawing on our experience and knowledge of health care policy and Medicaid programs, we created a strategy for the CBO to present the value of its evidence-based family therapies to existing and potential partners.
As the health care consulting division of UMass Chan Medical School, Commonwealth Medicine has a long and successful history of health system transformation. We have proven qualifications with federal and state health and human services agencies and our in-depth knowledge of Medicaid programs make us the ideal partner for CBOs.
In addition to performing a deep dive into the literature and framing service value, our Health Law & Policy solution experts can also provide analyses of legislation and regulations. We have particular experience working with policies and programs for children and families, people with disabilities (including dual-eligibles), and people of all ages with complex, combined needs for mental health and substance use services. Our New York CBO partner found our help valuable:
“We know our services well, but never found the time to revamp how we communicated about them with current partners to advance conversations on quality and reimbursement. Commonwealth Medicine took the time to learn about our organization and developed a versatile deliverable that we can use for a variety of future meetings.” Shannon Ghramm-Smith, LCSW. SVP, Child Welfare & Behavioral Health Division. Senior Advisor, NYF Implementation Support Center. The New York Foundling.