Partnerships between social service organizations and health care providers are emerging across the country. Working with hospitals, physician groups, and insurance companies can drive improved outcomes for those experiencing homelessness in their community.
These partnerships can bring additional resources and funding to an organization — but they can also be difficult to negotiate. Here are five health care concepts to understand as you approach potential partners.
1. Fee-for-Service (FFS)
This is the traditional model for treating patients and receiving reimbursement. A doctor or other health care provider is paid a fee for each service rendered, regardless of the outcome. There is little incentive to broaden perspective beyond the acute problem, or to gain insight into the root causes of the issue.
This is problematic because 89 percent of a person’s health is influenced by non-medical factors, including 24 percent from social circumstance and 7 percent from the patient’s environment. By not accounting for these factors, we perpetuate a health care system that is inefficient, costly, and does not produce quality health outcomes. Broadly speaking, the health system is designed to treat the symptoms and not the causes of poor health.
2. Value-Based Care (VBC)
Value-based care focuses on the quality of care provided, and rewards health care providers for both efficiency and successful outcomes. VBC changes the paradigm for health systems and insurers to focus on successful long-term quality outcomes and preventative care, rather than transaction-based treatment for the immediate problem. Key benefits of value-based care are:
- Patients spend less money for better health;
- Insurers control costs and reduce risk;
- Health systems achieve greater efficiency, cost reduction and better outcomes;
- Suppliers align prices with patient outcomes; and
- Ultimately, the population’s health is improved.
3. Population Health
The Centers for Disease Control and Prevention (CDC) describes population health “as an interdisciplinary, customizable approach that allows health departments to connect practice to policy for change to happen locally. This approach utilizes non-traditional partnerships among different sectors of the community – public health, industry, academia, health care, local government entities, etc. – to achieve positive health outcomes.”
The CDC’s definition has been used and applied more as population health has evolved. The emphasis has been on partnerships between health systems and the community to provide more comprehensive care – including preventative care – and account for other factors outside the clinical environment to help reduce costs and improve outcomes.
4. Social Determinants of Health (SDoH)
According to the World Health Organization, “The social determinants of health are the conditions in which people are born, grow, live, work and age. These circumstances are shaped by the distribution of money, power and resources at global, national and local levels and are mostly responsible for health inequities – the unfair and avoidable differences in health status seen within and between countries.” i
Social service organizations are integral to mitigating the effects of health disparities associated with SDoH. Their expertise equips them to address disparities such as:
- Housing and Personal Safety
- Utility Payment Assistance
- Access to Nutritious Food
- Education and Employment
- Family and Community Support
- Financial Services
- Substance Use Treatment
- Mental Health and Disability Supports
SDoH can exacerbate, if not cause, certain medical conditions. Medical and social factors must both be treated to achieve overall health improvement. Race and ethnicity, citizenship status, sexual orientation, history of incarceration, gender identity, military service, discrimination, living conditions, and work conditions all contribute to health disparities.
Non-profits are accustomed to assisting people with their social needs. By partnering with health systems, both the clinical issues as well as the underlying social issues that contribute to poor health can be solved.
5. Health Equity & Disparity
According to the Bay Area Regional Health Inequities Initiative, health equity and disparity is determined by a number of factors. Traditionally, certain health inequities have been addressed by individual education, health care, and case management:
- Risk behaviors: smoking, inactivity, poor nutrition, violence, alcohol, sexual behavior
- Disease and injury: Communicable disease, chronic disease and injury
- Mortality: Infant mortality and life expectancy
Other factors can be addressed more effectively through community coordination, partnership, and advocacy:
- Social factors: Class, race, immigration status, gender and sexual orientation
- Institutional inequities: Businesses, schools, government agencies, not-for-profits, and laws and regulations
- Living conditions: Physical environment, social environment; economic and work environment; and service environment including social services, health care, education
Becoming conversant about these concepts is an important step to start a credible dialogue with health system leaders. It will assure them you understand their motives to achieve better outcomes more efficiently. It should also inspire them to learn how you can become partners in delivering overall health and well–being to our society.
For more on this topic, download the WellSky white paper: “Partnerships between CoCs & Health Care Entities Enhance Coordinated Care, Lead to Sustainable, and Successful Outcomes for Homeless Population.”