Accountable Health Communities

Have you ever asked what evidence is required to include food insecurity initiatives as part of covered health care services? We have a partial answer to that, through exploring one pathway for building and evaluating health care innovations at the Centers for Medicare and Medicaid Services (CMS).

The Accountable Health Communities (AHC) Model at the CMS Innovation Center is evaluating the impacts of screening, referral, and navigation services to address health-related social needs (HRSN). The organizations participating in the AHC Model began their programs in 2017 and completed them programs this year. Preliminary evaluations of the model are being made available, offering insights into promising practices and impacts in a variety of health care settings, covering 21 states and 328 total counties (both urban and rural).

We were fortunate to have an opportunity to interview Katherine Verlander, Deputy Division Director at CMS, about the AHC Model and what its evaluation could teach us about integrating food insecurity in health care. Those interviews were released as Part 3 to our Hunger Vital Sign Explainer Series.

Later evaluations will provide more detailed analysis of total impact on health care quality and costs. For an example of a food- and diet-related CMS Innovation Center model that has completed all the evaluation stages and was ultimately certified for expansion, see the Medicare Diabetes Prevention Program - Expanded Model. Nonetheless, as our series explains, there is a lot to learn from the materials already available.

Health Affairs has also run a blog post summarizing the preliminary findings “Lessons from 5 Years of the CMS Accountable Health Communities Model”.

Mathematica, a partner to the CMS Innovation Center in sharing the results of the AHC Model, also provided their own podcast on lessons learned, connected to the release of a guide to using the AHC Model’s HRSN Screening tool in 2021. You can listen to their podcast, On the Evidence, here.

The evaluations themselves are posted online at the CMS AHC Model website.