Innovations in Payer–Community Partnerships: The EmblemHealth Neighborhood Care Program

Abstract

Comprehensive and innovative strategies are needed to address and manage chronic diseases and conditions and to reduce health disparities. EmblemHealth Neighborhood Care (EHNC) sites provide community-based linkages across payers, health providers, and delivery systems and underserved communities using culturally sensitive methods tailored to meet the needs of the community. This article describes this novel initiative and early indicators of its feasibility. Three EHNC sites were established in New York City: Harlem, Cambria Heights, and Chinatown. Each site provides core health and customer services to members and the community. In addition, sites provide tailored services to meet the unique needs of each community. Preliminary data suggest that program and community members are utilizing the sites and returning for follow-up visits. Sites also demonstrate success in cross referral between EHNC teams. The EHNC program is both feasible from the payer’s perspective and acceptable to diverse patient populations and settings.

Keywords

community health disparities health promotion payer

Get full access to this article

View all access options for this article.

References

National Center for Chronic Disease Prevention and Health Promotion. The power of prevention: chronic disease: the public health challenge of the 21st century, https://www.cdc.gov/chronicdisease/pdf/2009-Power-of-Prevention.pdf (2009, accessed 30 July 2014).

Mokdad

Marks

Stroup

et al.

Actual causes of death in the United States, 2000. JAMA 2004; 291: 1238–1245.

Degaspari

. Payer partnerships and population health. Healthcare Informatics: The Business Magazine for Information and Communication Systems 2013; 30: 41–44.

Claffey

Agostini

Collet

et al.

Payer-provider collaboration in accountable care reduced use and improved quality in Maine Medicare Advantage plan. Health Affairs (Project Hope) 2012; 31: 2074–2083.

Cooper

Hill

Powe

. Designing and evaluating interventions to eliminate racial and ethnic disparities in health care. J Gen Intern Med 2002; 17: 477–486.

National Prevention Strategy, http://www.surgeongeneral.gov/priorities/prevention/strategy/report.pdf (2011, accessed 25 July 2015).

Institute of Medicine. Unequal treatment: confronting racial and ethnic disparities in health care, Washington, D.C.: National Academies Press, 2003.

Kodjo

. Cultural competence in clinician communication. Pediatr Rev 2009; 30: 57–63; quiz 4.

Cultural respect, https://www.nih.gov/institutes-nih/nih-office-director/office-communications-public-liaison/clear-communication/cultural-respect (2015, accessed 7 October 2016).

10.

Institute of Medicine. Crossing the quality chasm: a new health system for the twenty-first century, Washington, D.C.: National Academies Press, 2001.

11.

Kwan

Preston

et al.

Puentes clinic: an integrated model for the primary care of vulnerable populations. Perm J 2008; 12: 10–15.

12.

Gruen RL, Weeramanthri TS, Knight SE, et al. Specialist outreach clinics in primary care and rural hospital settings. Cochrane Database Syst Rev 2004: CD003798.

13.

Kaiser Permanente Community Fund at Northwest Health Foundation, http://www.northwesthealth.org/kpcf/ (2014, accessed 30 July 2014).

14.

Henry Ford Health System. Institute on Multicultural Health http://www.henryford.com/body.cfm?id=39779 (2014, accessed 30 July 2014).

15.

Community Partnership Fund, http://bit.ly/1uHzoWu (2014, accessed 30 July 2014).

16.

EmblemHealth. About us, http://www.emblemhealth.com/About-Us.aspx (2016, accessed 19 September 2016).

17.

Kumanyika

Ewart

. Theoretical and baseline considerations for diet and weight control of diabetes among blacks. Diabetes Care 1990; 13: 1154–1162.

18.

Bodenheimer

Wagner

Grumbach

. Improving primary care for patients with chronic illness: the chronic care model, Part 2. JAMA 2002; 288: 1909–1914.

19.

Barr

Robinson

Marin-Link

et al.

The expanded Chronic Care Model: an integration of concepts and strategies from population health promotion and the Chronic Care Model. Hosp Q 2003; 7: 73–82.

20.

King

Hinterland

Dragan

et al.

Community Health Profiles 2015, Manhattan Community District 10: Central Harlem. 2015; 10: 1–16.

21.

King

Hinterland

Dragan

et al.

Community Health Profiles 2015, Queens Community District 13: Queens Village. 2015; 55: 1–16.

22.

King

Hinterland

Dragan

et al.

Community Health Profiles 2015, Manhattan Community District 3: Lower East Side and Chinatown. 2015; 3: 1–16.

23.

Rimer

Glanz

. Theory at a glance: a health guide for health promotion practice, Bethesda, MD: U.S. Department of Health and Human Services, National Institutes of Health, 2005.

24.

National Diabetes Prevention Program, http://www.cdc.gov/diabetes/prevention/ (2014, accessed 30 July 2014).

25.

Bowen

Kreuter

Spring

et al.

How we design feasibility studies. Am J Prev Med 2009; 36: 452–457.

26.

Measuring your net promoter score, http://www.netpromotersystem.com/about/measuring-your-net-promoter-score.aspx (2016, accessed 28 September 2016).

27.

King

Hinterland

Dragan

et al.

Community Health Profiles 2015, Brooklyn Community District 8: Crown Heights and Prospect Heights. 2015; 32: 1–16.