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Community Partnerships: Key to Improved Care Delivery
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Community Partnerships: Key to Improved Care Delivery

Cardinal Innovations Healthcare is the largest specialty health plan in the country, insuring more than 850,000 North Carolinians with complex needs. Using a community-based model of care management, Cardinal Innovations has led the way in developing services, processes and solutions that improve the lives of our members and their families. Recognized for operational excellence, innovative solutions and superior outcomes for members, accuracy and speed of payments to providers, and cost-effective funds management, Cardinal Innovations is a leading healthcare company in the United States.
Elliot Clark is the senior community executive at Cardinal Innovations Healthcare.

Personalized care extends well beyond an individual’s clinical needs. In reality, numerous factors contribute to the overall health and well-being of the individuals we serve, including housing, transportation, and other social determinants of health (SDOH). Although healthcare organizations across the United States have begun to focus on how SDOH impact outcomes, the ability to address many of these elements often rests outside of the services that managed care providers offer.

For example, it’s one thing to ensure a patient receives medical treatment for anxiety. However, helping that individual successfully treat their condition requires a better understanding of their unique nonclinical needs. It’s then important to connect them with resources that can address the outside factors that may be contributing to their health concerns. Having resources at the ready can make all the difference.

That’s where strong community partnerships come in. To impact SDOH—and to provide truly personalized service to members—managed care organizations must create both a network of resources and a way to easily access the services that can help members deal with the whole picture. One way to do that is to tap into the wide variety of expertise that already exists within the community—from public health groups to school systems, housing authorities, civic organizations, social services departments, judicial systems, county governments, and many other organizations.

There are several steps managed care organizations that are seeking to increase their engagement in community initiatives can take:

  1. Start by identifying the gaps in each community. Seek to understand unique community challenges, then reach out to organizations already involved in solving those issues to find out their pain points. Ask them about existing programs that are working well, and about fledgling programs with the potential to create a strong impact if given the proper support. Then, build a matrix of what each organization brings to the table and identify what service offerings are missing. Determine the specific desired outcomes within the community. Once you’ve spoken to a range of community support groups, prioritize this list by the needs of the community and the potential benefits.

  2. Bring together organizations to fill those gaps. Create options for organizations to participate in both formal and informal ways. In some cases, it might make sense to develop contracts that clearly outline and fund certain services. In other cases, informal efforts can be just as effective. This may be especially true for groups and individuals with shared interests around a common theme—such as finding jobs for mothers who are homeless or supporting newly sober individuals. While these groups may not operate on a formal charter or contract, their participation can be invaluable and should be encouraged and supported.   

  3. Create sustainable, recurring options. Keeping programs intact over the long term should be a high priority for any managed care group looking to support stronger community initiatives. Identify how these programs will benefit the participants while helping the shared mutual population. If possible, consider investing in those community initiatives that have the potential to contribute significantly to improved outcomes. At Cardinal Innovations Healthcare, for instance, we’ve found success with our Community Reinvestment Initiative.

    This program identified and funded dozens of high-impact projects, including career college mentorships, rapid response housing, and support for the victims of domestic violence and human trafficking. One example of its positive benefit is a program that provides behavioral health telehealth assessments for the detainees at some county correctional departments. Recidivism rates have gone down in all 5 counties where it’s been implemented. For one gentleman in particular—who suffers persistent mental illness and was well known as a “frequent visitor” at the county jail—an assessment lead to Assertive Community Treatment (ACT) instead of charges. He hasn’t been back in jail for 8 months to date.  

  4. Boost educational efforts. To drive positive change, it’s important that participating organizations have opportunities to benefit from each other’s knowledge. Fortunately, education is one of the easiest ways to make an impact. It often takes few resources beyond staff time, and many times training can be cosponsored or shared. Examples might include offering Mental Health First Aid training at the local community center, child cardiopulmonary resuscitation at the local school, or HIV awareness training at the local public health center. The goal should be to provide robust, comprehensive training across targeted focus areas within the community.

  5. Address concerns around data sharing. Sharing data and information can be a complicating factor, especially with HIPAA and other privacy policies guiding the need to protect member and patient data. Yet the ability to communicate and share data can be hugely impactful—and it is key to being able to move quickly to increase collaboration and care quality. There’s no question that figuring out the optimal technology and the best way for technology systems to communicate can be challenging and expensive. The reality is that sometimes it takes invested parties willing to bring data together manually—at least initially—to show potential results and help justify larger investments.
It Takes a True Partner

Ultimately, the important thing is to start having these conversations. Strong partnerships make strong communities.

Improving care quality requires all of us to be willing to be a little vulnerable. We have to share our experiences and show where care gaps exist before we can move forward together to fill them. Managed care organizations seeking to heighten their impact on the community and pave the way for better health outcomes can start by looking outside of their own walls and partnering with organizations that stand ready to drive positive change.

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