Health and Disability

Dramatic changes in health care have propelled social service integration to the forefront of health policy and care delivery transformation discussions. The Affordable Care Act has expanded health insurance to millions of low- and modest-income Americans, many of whom have social, environmental, and behavioral concerns that often define their health. Additionally, the spread of alternative payment models—accountable care organizations (ACOs), bundled payments, components of the Medicare Access and CHIP Reauthorization Act (MACRA)—increasingly hold health care providers financially accountable for patients’ health and the cost of treatment. As a result of these trends, health care providers are keenly interested in exploring ways to integrate health and social services. For the first time, linking medical and nonmedical services can help providers meet their bottom line—it is no longer just an act of charity.

In light of these opportunities—the emerging evidence, evolving financial incentives, and lingering operational questions from health systems—the Commonwealth Fund has initiated an investment in projects to produce information that will help health care payers and providers connect medical and nonmedical interventions to reinforce their organization’s financial and quality of care goals. As we are on the staff of a health care and health policy foundation, this is new terrain for us.

The Commonwealth Fund’s Health Care Delivery System Reform program has outlined the following criteria to help guide our selection of projects to fund: (1) those having results that support the mission of health care organizations, providers, and payers; (2) those run by risk-bearing organizations, since they are more likely to have a financial interest in nonmedical interventions; and 93) those that will accrue benefit to the health care sector in the near term (for example, within five years). By appealing to providers’ and payers’ vested interests, our approach seeks to inspire these groups to think more expansively about health to include patients’ social needs.