By Rebecca Sax, Program Manager for National Initiatives

Why regional convenings?

In our work across the country, system administrators and providers alike have expressed a lack of communication and knowledge between stakeholders as a key barrier to collaborative care for individuals with complex needs. To address these concerns, we set out to bring together three groups of complex care stakeholders across the country. This complex care regional convening project aims to reduce the barriers to information-sharing and collaboration on a regional level and to foster ecosystems of complex care, as outlined in the Blueprint for Complex Care.

In May, we announced the host organizations for the three 2019 convenings: Atlanta Regional Collaborative for Health Improvement, California Association for Public Hospitals/Safety Net Institute, and Jefferson Healthcare. These convenings will take place between October 2019 and January 2020, and will cover topics of resource referral networks, peer health workers, and social isolation in older rural adults, respectively.

The results of the application process were informative as the Camden Coalition’s National Center for Complex Health and Social Needs continues to expand its network and offerings. With over 50 applicants, we were introduced to many innovative organizations and complex care ecosystems that were unknown to us before this process and got an overview of issues encountered by communities nationwide.

Selection process

To ensure that the convenings would be anchored in and tailored to each community, we created a Request for Information for local host organizations. The application asked that potential hosts identify a regional issue to address through a convening, act as a co-design convening partner with the National Center, and provide general expertise and information about the strengths and challenges of their own community to support the planning process.

By the end of the application period, we received over 50 proposals for three available host organization slots. Applications were reviewed by the internal National Center team and members of the National Center Advisory Committee. Both groups reviewed for the following criteria:

• Does the organization represent themselves as anchored in their community?
• Does the issue identified represent a barrier in the field of complex care?
• Is it possible to make progress on the issue through convening?
• To what extent are consumers incorporated into the planning/implementation of the convening?

Results

Who applied?

We were incredibly impressed by the quality and breadth of the applications. Applicants were primarily based in healthcare, followed by academia and research, social services, and advocacy.

Organizations submitted applications from twenty-two states, the majority of which were Medicaid expansion states with well-established complex care infrastructure (e.g. payers and government bodies have invested in innovation and sustainability of these programs). 

Common themes

While each application was specific to the host organization’s specific community, there were some common themes that emerged:

Rural health

Rural and frontier communities encounter unique barriers not always considered in urban-based programs. These areas may experience both a lack of transportation and logistical barriers to telehealth programs due to unreliable internet or phone connection. There is a critical lack of available services and medical providers, causing even more barriers to healthcare access. Patients and providers alike can be prone to social isolation.

Social needs screening and referrals

Thanks to Accountable Health Communities and other high-profile initiatives, more and more healthcare and community-based organizations are incorporating screening for social needs into their workflows. Many applications focused on implementing this process in their communities, while some organizations emphasized the need for a robust referral system to accompany any screening.

Addiction

We expected to receive a number of applications centered on addiction; however, there was an impressive range of approaches to this widespread issue. There were some communities that identified opioids as a significant issue, with an emphasis on long-term opioid recovery and family-based interventions. Other applications focused on specific issues related to alcohol addiction and pre-arrest diversion initiatives.

Special populations

Applications also indicated growing familiarity with complex care from more specialized sub-populations, e.g., children with complex medical conditions, people with physical and intellectual disabilities, and older adults. We were excited to see that programs targeted to these populations consider their work reflected in complex care and are interested in expanding their ecosystems of care.

Lessons learned (so far)

The regional convening project so far has been an incredible learning opportunity for the National Center. In reflecting on the process so far, here are the initial takeaways:

• Based on the number of project applications, there is clearly a significant desire for increased regional connectivity. We saw a particularly high response rate from areas with institutional support from state Medicaid and payer partners. This may indicate that organizations interested in implementing complex care require some level of existing infrastructure to participate in programs like the regional convening project.
• Each National Center initiative provides an opportunity to maintain our connection with existing stakeholders and build relationships with new partners. This project has allowed us to connect with organizations across the country, demonstrating that the network of complex care programs and providers is growing as practitioners start to either adopt complex care principles or recognize their work in complex care principles.
• In addition to regional collaborations, applications also noted a desire to create and maintain national connections between programs with similar approaches, populations, or barriers. The National Center aims to meet this need by offering opportunities to convene and collaborate, such as our annual conference Putting Care at the Center, our Virtual Learning series, and a new Core Competencies working group.

Next Steps

The National Center will collaborate with the three selected host organizations this year to plan, implement, and communicate about their respective convenings. Stay tuned through our newsletter and social media for more information about the outcomes of these events. 

You can also connect with representatives from each organization at Putting Care at the Center 2019, November 13-15th in Memphis, Tennessee. Early bird tickets on sale now through August 31.