ACO and social service organization partnerships: Payment, challenges, and perspectives

The integration of clinical and health-related social needs is both essential and elusive. This study highlights components of the Flexible Services Program in Massachusetts, a novel demonstration project of the Delivery System Reform Incentive Payment program under a Medicaid section 1115 waiver. The program allows the state’s Medicaid ACOs to pilot evidence-based initiatives that address a member’s health-related social needs in an effort to improve health outcomes and reduce total costs of care. An examination of payment mechanisms established in the partnerships between the ACOs and the social service organizations, combined with interviews with leaders of the ACOs, reveals strengths and outstanding challenges that must be addressed. More attention is needed to vet partnerships and to develop process or outcome measures that demonstrate meaningful impact for patients related to care utilization, equity, experience, and chronic health conditions.