This study tests the feasibility of a multi-sector tribally-operated data system and dashboard for documenting health and social service needs and service referrals among youth members of the Coeur d-Alene tribe. The integrated data system is designed to achieve data sovereignty and improve timeliness and coordination in the delivery of health and social services for the tribal youth population, thereby dismantling forms of structural racism and inequity created by reliance on fragmented non-tribal service delivery and financing systems.

This study investigates whether a novel type of social bond can pool resources across multiple competing health plans and create stable, long-term financing for interventions that address social determinants of health. The bond's design would allow multiple health plans participating in Minnesota’s Medicaid program to invest collectively in a fund that finances community-based interventions targeting social issues such as food insecurity, housing instability, transportation, and structural racism.

This study, funded as part of the Robert Wood Johnson Foundation’s Systems for Action research program, pilot tests a novel community-embedded, technology-supported overdose response intervention that aligns medical care, public health, and social service systems to improve outcomes for persons following the experience of an overdose among people living in the Skid Row area of Los Angeles, CA. The intervention proposes to dismantle the structural racism that channels marginalized communities into overburdened low-resource medical systems with limited capacity to address underlying health and social needs, and that excludes these communities from having a voice in how these systems operate.

This study, funded as part of the Robert Wood Johnson Foundation’s Systems for Action research program, assesses effective strategies to eliminate disparities in access to COVID-19 vaccination by race and ethnicity by building on an existing nationwide initiative of the Aging and Disability Vaccination Collaborative (ADVC). The ADVC, administered by USAging with funding from the U.S. Administration for Community Living, supports community-based organizations (CBOs) to facilitate seasonal vaccinations by aligning social services, public health and health care.

This study examines how the allocation of resources across medical, social, and public health services at the county level influences the relative success in controlling the progression of the COVID-19 pandemic. The project focuses on resource allocation decisions across sectors as a collective impact process that may influence the ability of organizations to cooperate effectively across sectors in responding to the pandemic.

This study tests how a transit system can enhance substance abuse treatment outcomes and reduce provider-level treatment costs for substance abuse amidst the opioid crisis in Connecticut. Increasing access and retention in treatment services is critical to improving health outcomes and reducing substance abuse overdose deaths. Using a difference-in-differences method, the research project will test how treatment costs differ before and after a new transit line and/or a change in transit service schedules.

Current health care payment methods do not reflect the need for effective chronic disease prevention, nor do they address the social determinants of health. Historically, common payment standards intended to link private healthcare providers with payers did not factor in coding or language to cover services provided by nonmedical personnel. Nonmedical personnel, specifically those in the social services sector, remain at a financial disadvantage relative to their peers.

Low socioeconomic status and other social risk factors are linked to poor health outcomes and increased emergency department (ED) visits. Assessing and addressing these social risk factors can help improve these outcomes. However, connecting social services organizations addressing these risk factors with organizations providing medical services can be very challenging, due in part to systems that do not “talk” to each other. In this study, researchers will evaluate how implementing a web-based communication and care management platform supporting electronic communication between patient-centered medical homes and social service providers affects care for Medicaid patients.

A vast majority of older Americans who are eligible for federal nutrition assistance programming remained un-enrolled, placing them at increased risk of food insecurity and its associated adverse health conditions and healthcare costs. A research team led by Benefits Data Trust and the UPMC Center for High-Value Healthcare will study the health and economic effects of a novel health plan strategy to increase benefit program enrollment.