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Findings suggest the model reduced emergency department visits for Medicare and Medicaid beneficiaries but not necessarily through the expected pathways
RESEARCH TRIANGLE PARK, N.C. — A pair of papers from experts at RTI International, a nonprofit research institute, suggest the Accountable Health Communities (AHC) Model, a five-year initiative designed by the Centers for Medicare & Medicaid Services (CMS) Innovation Center, was associated with statistically significant reductions in emergency department visits for both Medicaid and Medicare beneficiaries during the first 2.5 to 3.5 years of model implementation. However, these impacts may not have resulted through the expected pathway of increased connections to community service providers.
Both papers were published by Health Affairs on Wednesday and will appear in the journal’s June issue.
One of the papers, “Health Care Impacts Of Resource Navigation For Health-Related Social Needs In The Accountable Health Communities Model,” presents interim findings that AHC had some intended effects, including a reduction in ED visits among participating beneficiaries, but did not result in a statistically significant impact on total medical expenditures.
The evaluation is ongoing and will continue to produce estimates of the model’s impact on health care expenditures and other outcomes, as well as capturing impacts in several important subpopulations of Medicaid and Medicare beneficiaries, according to the authors.
“Our findings provide some positive evidence that engaging with beneficiaries who have health-related social needs can affect health care outcomes,” said lead author Will Parish, Ph.D., a health economist at RTI.
The other paper, “Addressing Health-Related Social Needs Via Community Resources: Lessons From Accountable Health Communities,” found AHC did not significantly increase the rate of community service provider connections or the rate of resolving beneficiaries’ needs, relative to a randomized control group. The authors suggest this could be due to individuals in the intervention and control group both receiving referrals for resources and beneficiaries in both groups using the informal support of family and friends to help resolve their needs. It may also highlight the challenges associated with addressing health-related social needs, they note.
“AHC represented a shift within the health care sector and federal health policy toward a patient-centered approach that recognized how health-related social needs can contribute to poor health outcomes,” said Jeanette Renaud, Ph.D., a health research psychologist at RTI and lead author of the paper. “While we did not find evidence that the model resulted in more connections to community service providers, we have found that there were significant and meaningful impacts on health care outcomes for these patients. This means that there’s room for additional research to explore what it is about AHC that produced good health care outcomes and to better understand how federal programs can best meet the social and health needs of patients.”
AHC was introduced in 2017 to test whether addressing Medicare and Medicaid beneficiaries’ health-related social needs, also referred to as social determinants of health, would impact health care costs and reduce health care utilization. It concluded in 2021.
Learn more about the Accountable Health Communities Model
Learn more about the methods used in these papers and additional AHC model evaluation findings
Learn more about RTI’s health care transformation work
