CMS selects 32 organizations to help bridge gap between clinical and community services

CMS announced Thursday that 32 organizations, including hospitals and health systems, will receive funding to test innovative approaches to link Medicare and Medicaid beneficiaries with community services to address their health-related social needs.

CMS will implement the program, called the Accountable Health Communities Model, over a five-year period. The program includes three pathways for participation: the Awareness Track, Assistance Track and Alignment Track.

The Awareness Track is designed to increase Medicare and Medicaid beneficiary awareness of available community services by spreading information about the services and through referrals.

Under the Assistance Track, organizations will help high-risk beneficiaries access services to address health-related social needs such as food insecurity, housing instability and interpersonal violence.

The Alignment Track is designed to encourage partner alignment to ensure community services are available and responsive to the needs of beneficiaries.

"We know that innovation at the state and community level is essential to improve health outcomes and lower costs," said Patrick Conway, MD, deputy administrator for innovation and quality at CMS. "In this model, we will support community-based innovation to deliver local solutions that address a broader array of health-related needs of people across the country."

Beginning May 1, 12 organizations will participate in the Assistance Track and another 20 will participate in the Alignment Track. The participating organizations represent rural and urban communities across 23 states. CMS said it expects to make announcements related to the Awareness Track this summer.

Access the full list of organizations participating in the model here.

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