Preparing CBOs to Participate in the New Health Safety Net

In the changing health care landscape of today, hospitals are being incentivized to keep patients out of the hospital and in community settings for as long as possible. The aim is to improve quality while also reducing the cost of care resulting from unnecessary reliance on hospital settings. In addition, there is an increasing awareness of the “social determinants of health,” as well as the socio-economic life circumstances that contribute to preventable hospital admissions, readmissions, and emergency room use.

In an effort to tackle these issues, health reform and NYS Medicaid redesign, particularly under the Delivery System Reform Incentive Payment (DSRIP) program, are driving the formation of network relationships between health care providers and an ever wider range of community-based care, support, and social service providers. Although many of these community agencies now count themselves as network partners within the DSRIP program, it is unclear what role they will play.

Community-based organizations that have a major impact on individual and family health but that have not been part of the health system in the past, may find new funding possibilities in DSRIP, but there are many questions about their readiness:

1. How many and what type of social service and allied health providers are becoming network members of DSRIP programs, ACOs, or Health Homes?
2. What role does it look like they are or will be playing?
3. What sort of financial or capacity building outlay or upfront investment has been required of them, if any?
4. Does participation require the development of new or modified program services?
5. Are there examples health Center/social service partnerships that have already been forged? What are the keys to a successful partnership of this sort, and what are the mine fields that require adept navigation?
6. Are these arrangements resulting in increased revenues (e.g., in the form of Medicaid reimbursements, hospital contracts, etc.) or referrals for these agencies? Is it likely that they will result in these benefits?
7. Are these arrangements resulting in outcomes beneficial to the health providers, e.g., improved quality of care, reduced re-admissions, etc.?
8. What are the implications of these arrangements for the stability, business models, sustainability of these community based social service agencies? Are there any downsides, even if new revenue or referrals were to come in?

Presenters

• Tony Hannigan, President & Executive Director, CUCS
• Kathryn Haslanger, CEO, JASA
• Irene Kaufman, Executive Director, Bronx Partners for Healthy Communities; Senior Vice President, SBH Health System
• Kevin Muir, Vice President, Health Link Program, CAMBA
• Andrea Thomas, Associate Executive Director, Home Care Services, Sunnyside Community Services
• Doug Wirth, President & CEO, AMIDA Care
• Rachael Pine (Moderator), Program Officer, Altman Foundation

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