Community-based organizations' perspectives on piloting health and social care integration in North Carolina

Raman Nohria; Junette Yu; Karissa Tu; Grace Feng; Shemecka Mcneil; Fred Johnson; Michelle Lyn; Karen Scherr

doi:10.1186/s12889-023-16722-4

Community-based organizations' perspectives on piloting health and social care integration in North Carolina

BMC Public Health. 2023 Oct 4;23(1):1914. doi: 10.1186/s12889-023-16722-4.

Authors

Raman Nohria¹, Junette Yu², Karissa Tu³, Grace Feng⁴, Shemecka Mcneil⁵, Fred Johnson², Michelle Lyn², Karen Scherr²

Affiliations

¹ Department of Family Medicine and Community Health, Duke University School of Medicine, 2100 Erwin Road, 27705, Durham, NC, USA. raman.nohria@duke.edu.
² Department of Family Medicine and Community Health, Duke University School of Medicine, 2100 Erwin Road, 27705, Durham, NC, USA.
³ University of Washington School of Medicine, 1959 NE Pacific St, Seattle, WA, 98195, USA.
⁴ University of California San Diego School of Medicine, 9500 Gilman Dr, La Jolla, 92093, CA, San Diego, USA.
⁵ Slice 325, Durham, NC, USA.

Abstract

Background: Community-based organizations (CBOs) are key players in health and social care integration initiatives, yet little is known about CBO perspectives and experiences in these pilot programs. Understanding CBO perspectives is vital to identifying best practices for successful medical and social care integration.

Methods: From February 2021 to March 2021, we conducted surveys with 12 CBOs that participated in the North Carolina COVID-19 Social Support Program, a pre-pilot for North Carolina's Medicaid Sect. 1115 demonstration waiver program that addresses social drivers of health.

Results: CBO participants preferred communication strategies that involved direct communication and felt clear communication was vital to the program's success. Participants expressed varied experiences regarding their ability to handle a changing volume of referrals. Participants identified their organizations' strengths as: strong organizational operations, past experiences with and understanding of the community, and coordination across organizations. Participants identified challenges as: difficulty communicating with clients, coping with capacity demands for scaling services, and lack of clear processes from external organizations. Almost all CBO participants expressed enthusiasm for participating in similar social care transformation programs in the future.

Conclusions: CBO participants in our study had broadly positive experiences in the pilot program and almost all would participate in a similar program in the future. Participants provided perspectives that can inform health and social care integration initiatives, including strengths and challenges in such programs. To build and sustain health and social care integration programs, it is important to: (1) support CBOs through regular, direct communication that builds trust and power-sharing between CBO and health care entities; (2) leverage CBO community expertise; and (3) pursue an individualized assessment of CBO capacity and identify CBO capacity-building strategies that ensure program success and sustainability.

Keywords: Health and social care integration; Health-related social needs; Medicaid population; Social determinants of health.

Publication types

Research Support, U.S. Gov't, Non-P.H.S.
Research Support, Non-U.S. Gov't

MeSH terms

COVID-19* / epidemiology
Health Services
Humans
North Carolina
Organizations
Social Support