![]() Encouragement of alignment between clinical and community services to ensure that community services are available and responsive to the needs of community-dwelling beneficiaries.Īs of April 2022, there were 28 organizations participating in the Accountable Health Communities Model.Ī federal evaluation of the model is underway, and CMS will post results on this page when available.Provision of navigation services to assist high-risk community-dwelling beneficiaries with accessing community services and.Referral of community-dwelling beneficiaries to increase awareness of community services.Screening of community-dwelling beneficiaries to identify certain unmet health-related social needs.This model promoted clinical-community collaboration through: ![]() Unmet health-related social needs, such as food insecurity and inadequate or unstable housing, may increase the risk of developing chronic conditions, reduce an individual’s ability to manage these conditions, increase health care costs, and lead to avoidable health care utilization. The Accountable Health Communities Model was based on emerging evidence that addressing health-related social needs through enhanced clinical-community linkages can improve health outcomes and reduce costs. ![]()
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