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Social determinants of health contracting with community-based organizations remains a complex and challenging task for payers as the demand for answers grows more pressing.
As the industry’s awareness of social determinants of health expands, so does the need for evidence-based solutions. Often, these solutions require health insurers and health systems to contract with community-based organizations that can address the issues more closely.
The share of community-based organizations entering into contracts increased from 2017 to 2018, according to a survey from Miami University’s Scripps Gerontology Center. The survey focused specifically on community-based organizations that served seniors, since the Center conducted the survey on behalf of the Aging and Disability Business Institute.
Of the more than 700 respondents, 41.3 percent currently had one or more contracts and an additional 16.8 percent were not in contracts but were pursuing one. Most organizations contracted with Medicaid managed care organizations (41.6 percent) and state Medicaid programs (28.5 percent). Around 18 percent contracted with a commercial payer.
Despite the rise in contracts between community-based organizations and payers or other healthcare entities, the efficacy of these contracts and contracting processes remains unclear.