As an advocacy organization, we are focused on highlighting the innovative and important work of organizations across the health care and social services sectors to blend and braid funding streams, and share data across sectors, to better coordinate care and improve health outcomes. We hope that this page will serve as a resource of existing studies, literature and examples/best practices on blending and braiding and data sharing.
Coordinating Funding & Data to Address SDOH
Addressing social determinants of health requires coordinating services, benefits, and care across both the health care and social services sectors. Often, the funding and administration of each of these programs is siloed, with minimal flexibility to leverage health care funding to pay for social needs, or to share data across programs on eligibility, enrollment, or utilization of services. Organizations across the country have long worked to close these gaps and find ways to coordinate across sectors, and recently there has been growing interest in aligning incentives and providing more flexibility and opportunities for programs to collaborate. Aligning for Health held a briefing highlighting programs and best practices on coordinating funding and data to address social determinants of health, featuring perspectives and examples from the federal government, state and local leaders, and their partners.
Opening Remarks were provided by:
Dr. Sandra Ford, Special Assistant to the President for Public Health and Science at the White House
Guest Panelists Included:
Erica Coletti, CEO, Healthy Alliance
Sue Polis, Director, Health & Wellness, National League of Cities
Amy Riegel, Executive Director, Coalition on Homelessness & Housing in Ohio (COHHIO)
Literature and Resources on Blending, Braiding, and Data Sharing
Health Leaders, “How Social IPAs Can Help Payers Deliver on Social Determinants.”
- This article highlights the Healthy Alliance as one of the first companies to adopt the medical independent practice association (IPA) model to meet social needs. This model takes the traditional IPA model of allowing independent providers to share resources and gain collective contracting power with payers and applying it to community-based organizations (CBOs). Healthy Alliance believes this approach is better than homegrown solutions given the need to unify, streamline, and deliver on SDOH infrastructure.
Healthy Alliance, “What Makes Our Network Special?”
- This infographic provides an overview of the Healthy Alliance and its work to address health and social needs in the State of New York. Healthy Alliance has expanded its network from six to 25 counties since 2018, and works to ensure there is no wrong door for New Yorkers to get connected to the services they need to address their health and social needs.
National League of Cities, “Transforming Systems to Improve Health & Equity.”
- The National League of Cities (NLC) Cities of Opportunity (CoO) initiative builds on the important role that city leaders play in address structural inequities through social determinants of health framework to improve equity and opportunity for all. NLC launched the Mayor’s Institute to Spur Job Creation and Economic Opportunity to Improve Health and Equity through COVID-19, in which six cities took part. This blog highlights NLC’s work with Tacoma, WA on an innovative approach to financing efforts to launch a new workforce development pilot that braids funding streams to strengthen opportunities for low-to-no income residents in the Salishan community.
National League of Cities, “Cities of Opportunity Theory of Change”
- The Cities of Opportunity (CoO) Theory of Change charts the vision that all city residents, particularly those historically excluded, have fair and equitable access to the resources and opportunities for good health and well-being – to shape vibrant, inclusive communities.
National League of Cities, “Cities of Opportunity: Pathway to Equity, A Brief Based on Analysis of Participating Cities.”
- Almost 86 percent of Americans live in cities. Impacted by local, regional and national conditions and events, cities are marked by continuous change, including becoming more racially and ethnically diverse over the last 10 years. This brief presents some of the innovative and transformational policies, systems, and programs developed and implemented by cities participating in Cities of Opportunity (CoO) and describes how the initiative has catalyzed their continuing equity work.
National League of Cities, “Addressing Mental Health, Substance Use and Homelessness”
- The broad goal of this project is to provide a resource to help city leaders implement effective strategies for emergency response and crisis stabilization for individuals experiencing mental illness, substance use disorder and/or homelessness. City leaders may adapt the strategies to address specific challenges related to these areas. Using a grant from Arnold Ventures, NLC worked to examine established city strategies and work directly with select cities to research, test and implement improvements.
National Academy for State Health Policy (NASHP), “Blending, Braiding & Block-Granting Funding for Public Health and Prevention: Implications for States.”
- Issue brief developed in collaboration with the de Beaumont Foundation and the Association of State and Territorial Health Officials, which provides analysis and recommendations for states interested in coordinating services and resources across programs.
Urban Institute, “Braiding and Blending: Managing Multiple Funds to Improve Health.”
- This blog is part of a series entitled “Uniting funding streams for health and social innovation,” a collaboration between the Urban Institute’s Pay for Success Initiative (PFSI) and The Brookings Institution-hosted Braiding and Blending Working Group. This series highlights the research of experts in health care financing focused on creative approaches to blending and braiding finance strategies to facilitate coordination of health care and social services and to aim to improve outcomes.
NASHP, “Braiding the Blending Funding Streams to Meet the Health-Related Social Needs of Low-Income Persons: Considerations for State Health Policymakers.”
- Issue brief highlights non-Medicaid funding sources that states could leverage through braiding or blending to better address social determinants or other needs that are not typically addressed by Medicaid.
Center for Health Care Strategies, “State Payment and Financing Models to Promote Health and Social Services Integration.”
- Issue brief reviews several financing mechanisms for states considering greater health and human service integration, with a focus on Medicaid. Suggested models described range from one-time seed funding to broader braiding and blending strategies. The brief also summarizes ways that states can better encourage providers to incorporate social services into their care.
HHS Office of the Assistant Secretary for Planning and Evaluation (ASPE), “Social Determinants of Health Data Sharing at the Community Level.”
- Report presents a landscape review of community-level efforts to address social determinants of health, including interviews with participants in three community-level initiatives that have built networks to coordinate clinical and social services. The report presents a cross-site analysis of the three initiatives, highlighting factors they identified as facilitating their efforts, the challenges they have faced, their plans for continued expansion, and opportunities for federal and state entities to contribute to their efforts.
CMS, “Using Z Codes: The Social Determinants of Health Data Journey to Better Outcomes.”
- Graphic outlines five steps for using SDOH Z codes and how doing so can enhance quality improvement initiatives.
Center for Health Care Strategies, “Screening for Social Determinants of Health in Populations with Complex Needs: Implementation Considerations.”
- Issue brief reviews key considerations for organizations to consider when seeking to collect and use data on social determinants to improve patient care.
National Governors Association (NGA), “Improving Human Services Programs and Outcomes through Shared Data.”
- NGA convened a small group of state and local agency leaders, researchers and other experts to discussed the ways “in which shared data can enhance the effectiveness and efficiency of public programs – for example, by reducing the time and burden of separate intake and enrollment systems; helping agencies better understand client needs, develop appropriate solutions and document outcomes and facilitating research that can inform policy decisions.”
NGA, “Using Data to Better Serve the Most Complex Patients: Highlights from NGA’s Intensive Work with Seven States.”
- Issue brief notes that “among the most critical elements in providing better care for [complex care patients] are data. Before state leaders can begin to address their super-utilizer populations, they first need to understand who those patients are, how they use the health care system, and how the state might adapt its system to meet patient needs.”