HIGHLIGHTS
- Can identifying—and treating—health-related social needs reduce health care costs and utilization?
- Abt used a mixed methods approach to evaluate AHC implementation and outcomes.
- Data from 2024 show decreases in Medicare and Medicaid healthcare costs from the model.
The Challenge
The Centers for Medicare & Medicaid Services (CMS) launched the Accountable Health Communities (AHC) Model to address the gap between clinical care and community services in the healthcare system. The AHC Model was based on emerging evidence that addressing health-related social needs could improve health outcomes. Abt, as a sub-contractor to RTI, tested whether systematically identifying and addressing the health-related social needs of Medicare and Medicaid beneficiaries through screening, referral and community navigation services would impact healthcare costs and reduce healthcare utilization.
The Approach
As part of Abt’s data collection, the team used a mixed methods approach to describe AHC communities and to gather data from model implementers and the Medicare and Medicaid beneficiaries they served. Abt’s main responsibilities within the evaluation included delivering community profiles, a beneficiary survey and beneficiary interviews, and a survey of and interviews with community service providers. Other parts of the evaluation included claims analyses, interviews with other stakeholders and a qualitative comparative analysis (QCA) of factors related to success.
The Results
After five years, the evaluation shows the model had mixed results. The model was successful in reducing healthcare costs, as Medicaid health expenditures decreased by 3 percent and Medicare decreased by 4 percent for beneficiaries in the Assistance Track. Beneficiaries with multiple needs saw larger reductions in healthcare costs and improved quality outcomes. However, the model resulted in only moderate increases in beneficiaries’ connection to community services and health-related social needs (HRSN) resolution. Taken together, the AHC evaluation offers potential for other systems planning to integrate healthcare and social services to improve community health and well-being.
Related:
- Accountable Health Communities (AHC) Model Evaluation – Third Evaluation Report (Nov 2024) | At A Glance Summary
- Addressing Health-Related Social Needs via Community Resources: Lessons from the Accountable Health Communities Model
- Accountable Health Communities (AHC) Model Second Evaluation Report (May 2023) | At A Glance Summary
- Accountable Health Communities (AHC) Model Evaluation First Evaluation Report (Dec 2020)
- AHC Model Fact Sheet: First 750,000 Completed Screenings