The Camden Core Model RCT shows us a path forward for complex care

Author
Kathleen Noonan
Date
January 8, 2020
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Results from the randomized controlled trial evaluating the Camden Core Model were published today in the New England Journal of Medicine. We are honored to share these findings with our community.

From 2014–2017, we partnered with researchers from J-PAL North America to measure the impact of the Camden Core Model on hospital readmission rates. The study showed similar readmission rates in the control and intervention groups at 180 days. The study also found that the Camden Core Model was associated with increased SNAP participation.

These results show that during our short-term intervention for people with very complex needs, we were unable to achieve reduced readmissions. Lowering readmission rates is just one of many goals we try to achieve through the Camden Core Model. The study was not designed to measure the Camden Core Model’s impact on other programmatic goals, such as increasing patients’ self-efficacy and strengthening relationships with medical providers. 

Furthermore, the results corroborate what we already knew: the healthcare system alone cannot fix the problem of complex health and social needs.

Every day, our care team sees that focusing solely on traditional healthcare is not sufficient for unraveling lifetimes of trauma and complexity. As a result, we have continually iterated on the Camden Core Model, adjusting our intervention and broadening our understanding of what drives healthcare utilization, even while the study was underway. This has led us to build on the Core Model in novel ways—among other innovations, we are now running a Housing First program and a Medical-Legal Partnership. We and our partners successfully advocated to the state of New Jersey to eliminate the prior authorization requirement for Medicaid-covered medications for addiction treatment. And we tailored the Camden Core Model for pregnant and postpartum women struggling with substance use disorders and for people awaiting release from the Camden County Correctional Facility.

Even more broadly, these results do more than confirm what we know about the limitations of healthcare-focused interventions: they show us a path forward that relies on strong cross-sector ecosystems of complex care in every community. People with complex needs are best supported when their community has ample high-quality social service resources, and when the healthcare options available to them are designed to meet their needs.

None of us can do this work alone. Our organization is more than just a non-profit running a healthcare intervention. We are organizations and individuals working together to make care better for people with complex health and social needs. We are part of a complex care ecosystem in our home community of Camden, NJ, helping to build capacity through efforts like the 7-Day Pledge and Safer Childbirth Cities as well as our on-the-ground patient facing work like the Camden Core Model, Housing First, and Camden Delivers. At the state level, we are founding members of New Jersey’s Regional Health Hub model, which supports unique, place-based non-profits to advance cross-sector convening and data sharing for the benefit of the state’s most vulnerable residents. And we do this work nationally through the National Center for Complex Health and Social Needs’ year-round programming to strengthen the emerging field of complex care.

We are not going to stop here: rather, we are continuing to analyze the data from the RCT in partnership with J-PAL North America and Rutgers University’s Center for State Health Policy. We are doubling down on our commitment to building complex care ecosystems here in our region, across the state, and throughout the nation. We remain dedicated to being a data-driven learning organization, and using what we learn to not only improve our own interventions but to contribute to a more effective, evidence-based field of complex care.

Finally, we could not have done this study without the hard work and dedication of our partners and staff. We especially thank the study participants, Camden Coalition staff, researchers from J-PAL North America, Cooper University Health Care, Virtua Health, Jefferson Health, the Camden Coalition Board of Trustees, and our member organizations.

Everyone committed to the work of complex care knows that progress takes time, whether you are engaging patients to help them meet their goals or creating cross-sector institutional partnerships. Progress is not linear. But we embrace this uncertainty and will continue to share what we learn—our patients depend on us to keep trying.

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