Accountable Health Communities Model (AHC) evaluation: Third evaluation report

This report focuses on several new analyses to answer previously unanswered research questions. We used qualitative comparative analysis to better understand which bridge organization and community characteristics were associated with better implementation outcomes. Implementation outcomes included higher levels of population reach through screening, connection to CSPs, and HRSN resolution and a higher likelihood of being able to sustain the AHC Model. For this report, we also conducted a comprehensive model fidelity analysis to understand the extent to which bridge organizations met overall and Alignment Track–specific model requirements. We also conducted new quantitative analyses to identify the beneficiary-level characteristics associated with a greater probability of accepting navigation, having at least one HRSN resolved, or having all HRSNs resolved.

The primary data in this report are comprehensive. Likewise, this report includes screening and navigation data through the end of all no-cost extension periods (April 2023). At the time of writing, claims data were not yet available for the entire performance period. Medicaid claims were available through December 2021, FFS Medicare claims were available through December 2022, and Medicare Advantage Encounter Records were available through December 2020.