California-based Adventist Health and in-home primary care provider Emcara Health are teaming up to bring care to high-risk seniors in communities across California. The partnership is part of California Advancing and Innovating Medi-Cal (CalAIM), a multiyear program aimed at closing care gaps for patients with complex needs by addressing social barriers that affect patient health.
“Emcara Health’s decadelong focus on delivering community-based care to vulnerable populations, highly experienced multidisciplinary care teams and nimble approach to non-traditional healthcare delivery made them the right partner to successfully realize the goals of the CalAIM initiative,” Shelly Trumbo, vice president of well-being at Adventist Health, said in a statement.
Tennessee-based Emcara Health will send teams of community healthcare workers into the field to meet patients in their homes, in homeless shelters or in emergency departments. The teams will engage with patients and conduct social determinants of health assessments to understand if barriers, such as food insecurity, transportation or stress, might be impacting their health. Emcara Health nurses and social workers will connect patients with clinical care support and wraparound services which may include care transitions, family assistance or other services.
Providers and payers increasingly are focusing on social determinants of health as a way to improve outcomes and keep healthcare costs down, especially for at-risk patients in underserved communities. Late last month, Socially Determined, a healthcare analytics firm focusing on social needs, received $26 million from a group of investors. In March, Nashville-based naviHealth, a provider of post-acute care management and care transitions, announced a new social determinants of health solution that coordinates social needs of patients transitioning from the hospital to home.
At least a quarter for Medicare Advantage plans have supplemental benefits that address social determinants of health, according to long-term care advisory firm ATI Advisory.
