Journal of general internal medicine
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This paper shares lessons learned from providing planning and technical assistance to the grantees of the Merck Foundation's 5-year, $16 million initiative, Bridging the Gap: Reducing Disparities in Diabetes Care, designed to improve access to high-quality diabetes care and reduce disparities in health outcomes among vulnerable and underserved U. S. populations with type 2 diabetes. Our objective was to co-create, with the sites, financial sustainability plans to sustain their work once the initiative had ended and to improve and/or expand it to serve more patients, better. ⋯ The sites were diverse in terms of their approaches to clinical transformation and integration of SDOH interventions, geography, organizational context, external environment, and populations served. These factors influenced the sites' capacity to build and implement viable financial sustainability strategies and the eventual plans themselves. Philanthropy has a critical role in investing in providers' capacity to develop and implement financial sustainability plans.
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Editorial
Integrated Interventions to Bridge Medical and Social Care for People Living with Diabetes.
Social drivers of health impact health outcomes for patients with diabetes, and are areas of interest to health systems, researchers, and policymakers. To improve population health and health outcomes, organizations are integrating medical and social care, collaborating with community partners, and seeking sustainable financing with payors. ⋯ This article summarizes promising examples and future opportunities for integrated medical and social care across three themes: (1) primary care transformation (e.g., social risk stratification) and workforce capacity (e.g., lay health worker interventions), (2) addressing individual social needs and structural changes, and (3) payment reform. Integrated medical and social care that advances health equity requires a significant paradigm shift in healthcare financing and delivery.