On January 5, 2016, the Center for Medicare and Medicaid Innovation (CMMI) released a funding opportunity announcement (FOA) soliciting grant applications to test whether identifying health-related social service needs, and promoting delivery of services to meet those needs, can help reduce health care costs and improve health outcomes for Medicare and Medicaid beneficiaries. The FOA sets forth CMMI’s “accountable health communities” (AHC) model for three tracks: screening and referral services (“track 1”); community service navigation for high-risk patients (“track 2”); and community service navigation, community partner alignment, and continuous quality improvement (“track 3”).
Local government agencies, private non-profit organizations, and for-profit organizations are eligible to apply under each track. Awards are expected to range from $1 million to $4.51 million over the five year grant performance period (January 1, 2017 – December 31, 2021). CMMI plans to evaluate results achieved through the AHC model using metrics such as impact on Medicare/Medicaid costs, reductions in hospital emergency department use, and reductions in hospital re-admissions.
When outlining the purpose of the AHC model, CMMI correctly notes that many health care systems have lacked sufficient infrastructure and incentives to collaborate with community-based social service organizations to achieve better health outcomes for high-risk patients. PCG has extensive experience evaluating Delivery System Reform Incentive Payment (DSRIP) projects that are helping to foster greater collaboration between hospitals and a wide range of social service organizations within communities afflicted with high rates of health risk factors and preventable chronic diseases, which account for more than 50 percent of all health care costs.
CMMI requires letters of intent by February 8, 2016. Complete applications, which must be coordinated with state Medicaid agencies, are due March 31, 2016. CMMI award announcements for up to 44 organizations are expected by November 1, 2016.
