What are ecosystems of care?

Camden Coalition staff work closely with local partners during the COVID-19 pandemic host vaccination events to alleviate vaccine hesitancy and reduce gaps in vaccine compliance in the community.

A ecosystem of care is a local network of organizations, sectors, fields, and/or professions working collectively to address the root causes of poor health among individuals with complex health and social needs.

Released in the fall of 2018, the Blueprint for Complex Care borrowed language from environmentalists in calling for the creation of ecosystems of care.

Ecosystems of care may include:

consumers and families,
health systems and practitioners,
diverse community-based organizations,
public health thinkers and doers,
social service and behavioral health organizations,
payers,
educators,
first responders,
faith-based organizations, and more.

Why does complex care take an ecosystem?

The interdependent collaborations that characterize ecosystems of care improve the effectiveness, efficiency, experience, and quality of care delivery by:

Sharing information. Sharing real-time, detailed information from multiple sources (i.e., community-based organizations, public health, and health systems) on an individual’s conditions, circumstances, and goals means all providers have a holistic view of the individual and can tailor care accordingly.
Leveraging existing trust and relationships. Community-based organizations may operate closer to where people live and have a deeper understanding of the population and community they serve. As a result, they are well-positioned to leverage strong, trusting relationships that allow for better care.
Specializing competencies to address specific needs. Knowing that the holistic needs of the individual are being met by partner organizations allows for specialization and efficiency in delivery. Using existing assets and leveraging potential partnerships in delivery creates a more integrated system of care.

President and CEO Kathleen Noonan addressing the importance of building ecosystems of care in her opening remarks at Putting Care at the Center 2019

The most powerful examples of successful ecosystems of care feature local and regional communities coming together, honestly evaluating their systems, understanding who’s at the table, and identifying who’s missing and marginalized. This is the hard work of building authentic, healing relationships—and it’s absolutely necessary.

How do I start building an ecosystem of care in my community?

Two National Center programs support local groups of stakeholders in starting and strengthening ecosystems of care in their communities:

Through our regional complex care convenings program, a cohort of host organizations convened groups of various stakeholders to address barriers to complex care in their communities.
The Ecosystem Community Learning Collaborative ran from spring 2021 to fall 2022 and was comprised of multi-organization collaboratives from six communities across the country. Each ecosystem site received technical assistance and coaching from the National Center, and met regularly as a group to learn from each other.

Beginning or building a complex care program?

The tools and resources in the Data & process improvement and Community mapping & collaboration sections of the Complex care startup toolkit will be most helpful in building an ecosystem if you already have a complex care program.

Hoping to build the business case for your complex care ecosystem or program?

Use the value case summary tool in the Building the value case for complex care toolkit to demonstrate the return on investment (ROI) of your program or ecosystem. Also, you can apply lessons from our recent evaluation examining perceptions of value of cross-sector collaboration toward serving populations with complex health and social needs.

Training a complex care team or want to improve your skills and knowledge as a provider?

The resources in the Integrated team collaboration and Systems complexity and context domains of our Implementing the core competencies: A toolkit to guide education and training are helpful for supporting a team in building a complex care ecosystem.