Initiative to assess social determinants of health gathers momentum

Some 110 community and clinical partners, as well as leaders of hospitals, behavioral health and government organizations, convened May 7 for the semi-annual Accountable Health Communities Model (AHCM) meeting in Grand Junction. The gathering was designed to build momentum and accelerate screening for social determinants of health in settings across the Western Slope.  
AHCM is a five-year project to test if systemically identifying and attempting to address patients’ health-related social needs (housing, food, utilities, safety, transportation) can reduce overall health care costs while improving health care quality and care delivery. Western Colorado was selected as one of 32 national sites to participate in this Center for Medicare and Medicaid Innovation initiative, which began in May 2017.
Rocky Mountain Health Plans, in close partnership with Mesa County Public Health, The Health Partnership of Northwest Colorado, West Mountain Regional Health Alliance and Tri County Health Network, has been actively building, nurturing and expanding an effective, person-centered accountable community in Western Colorado. It’s a daunting effort to fundamentally change health care delivery by aligning historically separate social, structural and care delivery streams: clinical health providers, mental and behavioral health providers and community-based social services agencies.
The May meeting was an opportunity to energize participants for the work ahead. The goals for the meeting included:
  • Build relationships across clinical and nonclinical partners;
  • Reconnect with and develop the vision behind the initiative;
  • Develop and refresh a deeper understanding of how poverty affects people’s access to health through experiential training; and
  • Engage in peer learning around critical aspects of implementation within AHCM.​
Round table discussions over lunch were led by 14 regional and national leaders, covering topics as diverse as calculating return on investment for organizations to pay for social health needs to addressing housing and food insecurity or responding to interpersonal violence.
The experiential learning included an exercise led by Heather Cunningham, national training director of Think Tank, Inc., which helped participants better understand the experience of poverty and what it means to those experiencing it.
“One participant said she’s been doing this work for a long time, but not really thinking about why they’re trying to do it. The training brought her back to the why,” says Sally Henry, AHCM project coordinator. “It’s easy to get stuck in the everyday workflow, in reporting and looking at numbers. This was a reminder that AHCM is about the people and the struggles they’re having. Going through that experience was a great reminder for everyone that these are real people with real lives, and it’s not easy for them.”