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

In 2017, the Center for Medicare & Medicaid Innovation (Innovation Center) launched the Accountable Health Communities (AHC) Model to test whether connecting Medicare and Medicaid beneficiaries to community resources can improve health outcomes and reduce costs by addressing health-related social needs (HRSNs)—adverse social conditions that affect health and health care expenditures.

The AHC Model has a 5-year period of performance beginning in May 2017 and ending in April 2022. Beneficiary screening began in summer 2018 following a preimplementation period. The Innovation Center funded entities known as bridge organizations to implement the AHC Model in communities across the country in collaboration with clinical delivery sites (CDSs), community service providers (CSPs), state Medicaid agencies, and other community stakeholders. Bridge organizations are predominantly health systems and hospitals but also include nonprofits, health information technology providers, academic institutions, payers, and a public health agency. The model had 29 participating bridge organizations as of August 2019—11 in the Assistance Track and 18 in the Alignment Track.