States looking to integrate health and social services, especially for Medicaid beneficiaries, can establish a system that would coordinate and finance a variety of services that affect health, including social supports and economic opportunities, according to a recent report from the Commonwealth Fund.
Listed below are three measures necessary for an integrated system of health and social services, as proposed by the Commonwealth Fund:
1. Develop an integrator
States can establish an organization or task force to coordinate communication across state-level services. The integrator would be responsible for engaging partners, relying exchange information and assessing data.
Such collaboration also is important at the community and provider levels. Coordinating mechanisms at the community level include health outcomes trusts and accountable care communities, while for providers, the Commonwealth Fund proposes Medicaid health homes and ACOs.
2. Measure outcomes and share data
States need to choose metrics, such as life expectancy from birth and self-reported levels of health, that reflect accountability goals. These measures should work among a variety of populations, notes the report.
To better share data, states need to create data-sharing tools that link information across payers and provider networks. Even before implementation of the Affordable Care Act, Maryland had established an all-payer claims database (APCD) to collect claims data from all commercial insurers within their borders, FierceHealthPayer previously reported.
3. Establish financing and payment methods
States need long-term financing sources to encourage integration. As one option, states can apply for grant funding, notes the report. Massachusetts, for example, established the Prevention and Wellness Trust Fund, which allocates almost $60 million over four years to fund competitive grants.
Bundled payments may be the best options for states to cover clinical and public health for their populations. States also could look to a more shared-savings approach, by mixing Medicaid and social services funds and then distributing them accordingly.
- here's the Commonwealth Fund report (.pdf)