In college, I had an internship at the Mobile County District Attorney’s office in a special unit that was formed to address the high and growing juvenile delinquency rate. The District Attorney saw an increasing problem in the court system, and set out to identify early interventions with potential to reverse the trend. He hired a savvy and seasoned team of social workers to work with high-risk kids, with the hopes that they wouldn’t become truants or delinquents.
The social workers traveled across the county as teachers and administrators identified students having issues in school—an increase in absences, grades that suddenly plummeted, or falling in with the wrong peer group. After gathering information about the student’s circumstances inside and outside of school, a group discussed the cases and any possible interventions. This group contained local mental health centers, food pantries, Big Brothers Big Sisters, housing organizations, literacy organizations, and other social service providers. With a plan in place, the team would work to connect each student and their family to the appropriate services and provide them with helpful resources.
Although I was only there a short time, the experience stuck with me. It was a smart use of existing resources to address a challenging problem, and it recognized that the problems these students were facing ran much deeper than what schools could address on their own. The early interventions were relatively inexpensive and holistic, and would avoid costly and lengthy use of the court system. I’m glad to see the same thinking being applied in Colorado’s health care system today, as well as some initial thinking nationwide.
In Colorado’s Medicaid, the way care is being delivered through the Accountable Care Collaborative (ACC) model is changing substantially. The state has a vision for 2017 to look outside of traditional health care settings for groups and resources that can improve patient health. Patients often struggle with things like transportation, food, and housing, and these barriers keep their health from improving. By connecting community organizations who serve these needs with Medicaid patients, it should improve patient health, decrease the need for intensive, costly treatment, and ultimately save money and lives. Colorado is fortunate to have a large number of trusted community resources, and CCMU is working with the state to ensure that these resources are leveraged in this evolution of the ACC. This is perfect timing, as the new Accountable Health Communities Model initiative, by the Centers for Medicare and Medicaid Services, is making funding available to support similar strategies across the country, with the intention of assessing the impact on quality and costs.
Although the calendar has just barely turned to 2016, it won’t be long before 2017 is here and the new ACC is taking shape. We look forward to seeing Medicaid lead the way in this more comprehensive approach to improving health in Colorado—and in similar initiatives around the nation.