For many health care institutions, the shift toward values-based payments is accelerating efforts to address housing, food, safety, and other community needs.

You might expect this is good news for local community-based organizations (CBOs) with relevant expertise. Yet, in our work with CBOs—including networks of CBOs whose structure is meant to make it easier to partner with large health care institutions—we’ve found there are significant hurdles for the field to clear before we’ll see the improved health outcomes that everyone wants.

Over the past several years, the importance of the social determinants of health in driving health outcomes has become widely accepted. But the question of who pays for the partnerships that address social determinants persists. NFF’s work on the ground shows us that CBOs in partnerships have largely been unable to move sustainable contracts forward with their health care partners. In almost all cases, contract discussions break down because health care partners are unable to commit to pay for the full cost of CBO services, including the upfront investments required. Health care partners consistently cite the political and policy landscape as a limiting factor in paying full cost. So, whose responsibility is it to pay?

If we’re going to realize the benefits of results-oriented approaches to health, there needs to be an investment in the organizations delivering critical services in our communities. Specifically:

  • Invest in infrastructure 
  • Build capacity
  • Know and cover the full costs of improved outcomes

Read the full article about partnerships to address the social determinants of health by Lisa Thirer at Grantmakers In Health.