New Studies Aim to Improve Health by Connecting Medical, Public Health and Social Systems

AURORA, CO—Systems for Action, a national program office of the Robert Wood Johnson Foundation, is pleased to announce four recipients of $2 million in research awards. These studies will test innovative mechanisms for aligning delivery and finance systems for medical, social, and public health services, with a focus on the effects of these mechanisms on health and health equity.

The need for better alignment across health and social services has become increasingly urgent as the economic and service disruptions caused by the spread of COVID-19 impact communities across the country. People with unmet health and social needs, already at higher risk of infection and complications, are seeing those needs compounded by job loss, school and business closures, and occupational risk due to the pandemic. Recovery will require increased alignment of medical care with the systems that support social services and public health programs in response.

The new studies will rely on rigorous scientific methods to evaluate the impact of coordinating these systems, focusing on key communities including families engaged with the child welfare system, low-income pregnant women, and people seeking substance abuse treatment. “These new studies will expand our toolbox of evidence-based strategies that help health and social systems work better together,” said Dr. Glen Mays, professor and chair of the department of Health Systems, Management and Policy at the Colorado School of Public Health and director of the Systems for Action program office. “By bridging these sectors, we can help individuals and communities thrive, and maybe even save money along the way.” The new research projects are:

Transit and Treatment: Aligning Systems to Address Substance Abuse in Connecticut

[Lead institution: University of Connecticut]

This study will look at how changes in public transit system service affect the use and costs of substance abuse treatment services in Connecticut. Researchers at the University of Connecticut are collaborating with the Connecticut Departments of Transportation, Public Health, and Mental Health and Substance Abuse along with local treatment providers to carry out the study. Findings will be used to engage transit officials, public health agencies and treatment providers in multi-sector planning and financing models that increase equity in access to care by optimizing the location of transit and treatment services. Learn more:

Aligning Delivery and Financing Systems to Prevent Adverse Child Experiences in St. Louis

[Lead institution: Washington University in St. Louis]

This initiative, Parents and Children Together - St. Louis, tests a new model for preventing child abuse and other adverse childhood experiences (ACEs). It brings together health and social services and funding to help families who are referred to child protective services (CPS) for first-1 time and low-severity problems. The study will evaluate the effectiveness of cross-sector collaborations as well as whether families access needed services, and subsequent CPS referrals and costs. Researchers at Washington University's Brown School of Social Work are collaborating with Vision for Children at Risk, Missouri Department of Social Services, St. Louis Housing Authority, St. Louis Department of Health and other community organizations across the city to conduct the study. Findings will be used to help communities coordinate successful financing and health and social service delivery models to prevent ACEs. Learn more:

Aligning Health and Social Systems to Expand Evidence-Based Home-Visiting

[Lead Institution: University of Colorado – Denver]

Nurse-Family Partnership (NFP) arranges for home visits from registered nurses to low-income first-time mothers in the U.S. Despite rigorous evidence of NFP’s ability to improve maternal health, child health, and economic security, NFP currently reaches only a small fraction of the people who could benefit from it. This study will use national, longitudinal data on NFP sites, including comparisons between healthcare-financed sites and social service-financed sites, to estimate how alternative financing and delivery collaborations can influence NFP implementation, reach, and outcomes. Researchers at the University of Colorado are collaborating with the NFP National Service Organization, Illuminate Colorado, and Children's Hospital Colorado to conduct the study. Findings will be translated into case studies and best practices that communities can use to expand the reach of NFP. Learn more:

Using Global Budgets and Multi-Sector Teams to Align Systems in Vermont

[Lead institution: University of Vermont and State Agricultural College]

This study tests the effectiveness of switching from a fee-for-service model to a global payment system in Vermont, the first to test global payment at a statewide level. This provides an incredible natural experiment that offers huge potential for learning. The study also tests whether, in a global payment system, providers can better coordinate wraparound services to improve health, equity, and social outcomes for Vermont residents. Researchers at the University of Vermont are collaborating with the Department of Vermont Health Access, OneCare Vermont, and the Green Mountain Care Board to conduct the study. Results will provide state and federal decision-makers with strategies for using global budgeting and multi-sector teams to improve control over health care costs and improve community health. Learn more:



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About Systems for Action: Systems for Action, a research program of the Robert Wood Johnson Foundation, is focused on discovering new ways of improving health and health equity by helping medical, social, and public health delivery systems work better together. The program now includes more than 25 individual studies underway across the U.S. that are testinga broad array of strategies for system alignment, including novel financing arrangements, alternative staffing models, new information and communication technologies, and collaborative governance and decision-making structures. Systems for Action is based in the Colorado 2 School of Public Health, University of Colorado, within the Health Systems, Management & Policy Department.

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