Healthy Alliance IPA Connects Patients With Social Needs to Social Services

The New York-based limited liability company has a network of more than 500 organizations serving 22 counties.

A limited liability company formed as part of the Medicaid redesign in New York State is helping managed care organizations and healthcare providers to connect patients with social determinants of health needs with social services.

Social determinants of health (SDOH) such as housing, food security, and transportation can have a pivotal impact on the physical and mental health of patients. By making direct investments in initiatives designed to address SDOH and working with community partners, healthcare organizations can help their patients in profound ways beyond the traditional provision of medical services.

The Alliance for Better Health was founded in 2015 as part of the Medicaid redesign in New York State. In 2018, Alliance for Better Health formed Healthy Alliance IPA as an affiliated limited liability company. The independent practice association helps managed care organizations and healthcare providers to connect patients with social determinants of health needs with social services.

"We have a network of participants, which includes clinical affiliates such as health systems in addition to social care providers. We have more than 500 of those organizations in the network, spanning 22 counties, with more than 1,000 social services. The services include transportation, food, housing, and job training," says Erica Coletti, CEO of the Troy, New York-based Alliance for Better Health.

Healthy Alliance IPA has many healthcare providers in its network, she says. "We have several health systems in our network such as St. Peter's Health Partners and Ellis Medicine. We have many primary care practices in our network. We also work closely with federally qualified health centers."

Healthy Alliance IPA plays an intermediary role between managed care organizations and healthcare providers and their patients, Coletti says. "We are a convenor that has put together a network of social service providers. We are providing the support and function around the social services network. … We work with multiple social service providers—we meet with them monthly to give them data on services they have provided through our network."

People are referred to Healthy Alliance IPA for social services in several ways, she says. "We get referrals from managed care organizations, health systems, hospitals, and physician practices. We also get referrals from community organizations—if they are working with an individual and they do not provide a service that the individual needs, they can make a referral to us."

Decreasing medical costs and improving health equity

Connecting people with social determinants of health needs with social services can reduce medical costs, Coletti says.

"A good example is someone who has diabetes with a blood sugar problem who has to go to the emergency room. If they had access to healthy food and nutrition counseling before they reached a crisis point, they could save significant medical dollars. Another example is someone with an addiction who needs to go to Narcotics Anonymous and transportation becomes a barrier for them. Unless you can provide a transportation service, that person can end up in an acute care setting. Addressing that barrier of transportation makes a big difference," she says.

Healthy Alliance IPA is also addressing health inequities, Coletti says.

"Our focus is on improving the health of the underserved. By addressing social issues that end up resulting in health issues, we expect to level the playing field by reducing social care barriers, which in turn will support health equity. The underserved disproportionately includes racial and ethnic minorities, and they have many more social determinants barriers than others. So, by removing those barriers and getting the underserved appropriate social supports, we are helping to level the playing field," she says.

Measuring the impact

Stanford University is going to be conducting a study to measure the impact of Healthy Alliance IPA, Coletti says.

"The Stanford University study is an economic study, so we will be looking at the past three years of data for people who are involved in our network and seeing whether the network bends the cost curve on medical utilization. So, we will be looking at cost of care, acute care utilization such as avoidable emergency room visits and hospitalizations, and health outcomes for people in the network versus comparable people who are not in the network. We will also be looking at the impact based on race and ethnicity."