Researchers Studying New Care Models for Promoting Equity

March 3, 2021
Cleveland’s University Hospitals is studying the use of case managers who will develop a long-term, relationship-based approach for vulnerable patients on Medicaid

With support from the Robert Wood Johnson Foundation (RWJF) and Avalere, nine research teams across the country are exploring models of care to better understand which components are essential to promoting health equity in the Medicaid population.

The nine research teams are focusing on an array of topics such as the connection between poverty and primary-care delivery models; care-coordination models; and relationship-based models to improve accessibility to care.

University Hospitals (UH) in Cleveland received a $300,000 grant to research a new UH-developed model that is designed to help patients with their physical and mental health as well as their social needs by teaming them up with case managers who will develop a long-term, relationship-based approach for vulnerable patients on Medicaid.

In a statement, Patrick Runnels, M.D., chief medical officer of population health and behavioral health at UH, vice chair of psychiatry at Case Western Reserve University, and principal investigator of the study, said the grant will help determine if this new type of model could help Medicaid patients better handle a range of complex issues in their lives.

"These patients have multiple, complex issues that are difficult for the individual to solve, or in some cases, patients themselves don't believe in their own ability to solve them, so they don't engage," said Runnels. "In addition, some don't believe the system can help them because they have no trust in it."

Nearly 170,000 patients in UH's accountable care organization (ACO) are on Medicaid. Nearly all of them have at least one area of severe social or economic distress. The study began in January and will collect data through June 2022. Data analysis will be complete by August 2022 at which point the conclusions will be submitted to RWJF.

Shelley White-Means, Ph.D., a professor of health economics at the University of Tennessee Health Science Center, is the principal investigator of a $298,368 grant to examine whether health outcomes for low-income individuals will improve if primary care delivery focuses not only on physical and mental health, but also on the effects of poverty.

White-Means will lead a team for the 18-month project to test how an established model of care, Transition to Success (TTS), which focuses on mental health, physical health, and poverty and its consequences, impacts healthcare delivery and outcomes for patients of Cherokee Health Systems, a nonprofit provider of primary care services to the poor and uninsured in Tennessee, with centers in Memphis.

In a statement, White-Means, a faculty member in the Department of Interprofessional Education in the College of Graduate Health Sciences and the UTHSC Institute for Health Outcomes and Policy, said this collaboration with Cherokee Health Systems and its centers in Frayser and the Parkway Village area represents a fundamental change in healthcare delivery by adding a third element to the current model that focuses on physical and mental health.

Heartland Health Centers and the University of Illinois School of Public Health received a $300,000 to collaboratively study the impact and effectiveness of the relationship-based care model initiated in 2019 at its Albany Park center.

In 2019, Heartland reorganized team roles at Albany Park to explore better ways to deliver care. They created a care team coordinator position as part of that process. 

“In our emerging new model, clinicians focus on the activities where they add the most value, and the care team coordinator ensures patient needs are tended to holistically,” said Jeff Panzer, M.D., Heartland Health Centers’ vice president of care transformation, in a statement.

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