#SystemsofCare

Two people filling out a form on a clipboard. The person holding the clipboard is a doctor.

U.S. Potential Path to Addressing Health-Related Social Needs: Drawing Lessons from State Innovations

Today, 40% of Americans face significant material hardship, which includes limited access to vital resources such as nutritious food, medical care, affordable housing, and essential utilities. Yet, the support provided by social service agencies and nonprofit organizations reaches less than 16% of those struggling with material hardship, leaving the majority to manage on their own. What happens when someone cannot pay rent or has a disconnected phone? These unmet health-related

Understanding U.S. Veterans and Military Connected Individuals’ Needs: A Conceptual Framework for Identfying the Level of Need and Co-occurring Needs

View the Resource By Marwa Tahboub, Tatum Thomas, Lucia Koo, Qiwen Zhang, Michelle Shumate Veterans, service members, and their families often seek a wide variety of assistance, including access to health and benefits services from the U.S. Department of Veterans Affairs (VA), housing and homeless assistance, and financial and employment assistance. These needs frequently co-occur and require the delivery of services by more than one organization. This research examines the

How Can States Build Better Relationships between Health Care Organizations and Community Based Organizations?

Healthcare providers, organizations, and payers recognize the connection between social needs and health outcomes. These social needs are often described as the social determinants of health (SDOH). SDOHs are the environmental and social factors that influence health outcomes. Research indicates that improving social conditions— such as adequate food, secure housing and income, access to healthcare, and dependable transportation — is crucial to addressing health inequalities and outcomes. With the increasing

Maintaining Systems of Care in the Midst of Shock

View the Resource By Joshua-Paul Miles, Marwa Tahboub, Zachary Gibson, Michelle Shumate The COVID-19 pandemic created massive disruptions across society. These disruptions put into focus integrated social service referral networks’, hereafter systems of care, ability to be resilient in times of crisis. This research examines 11 systems of care across the United States. The researchers compare network performance before and immediately following the emergence of the COVID-19 pandemic using quantitative

#SystemsofCareInsights: Policymaker Insights – Rethinking Evaluations and Using Multiple Measures (3/3)

Rethinking Evaluations: Navigating services related to health– housing, employment, transportation, etc.– can be extremely difficult. That’s why state leaders in North Carolina created NCCARE360, a network that provides public access to resources and aids organizations in collaborating on referrals. As the first statewide coordinated care network, NCCARE360 has onboarded over 2,500 organizations and helped over 42,000 users. But how can state leaders even get started creating a network like NCCARE360?

#SystemsofCareInsights: Accepting Tradeoffs and Capitalizing on Nuance (2/3)

Accepting Tradeoffs: Effective coordinated care networks require numerous moving parts to work together. Managers of these systems must acknowledge the inevitability of issues in their systems. When things go off course, it’s essential to recognize tradeoffs. Some metrics can be optimized at the expense of others. One of the main tradeoffs discovered by researchers in the IBM report is the interplay between accuracy versus efficiency. For coordinated care networks, better