Evaluation Finds Local Community Care Networks Do Not Reduce Costs, Show Some Improvement in Health Status
From 1996 to 2001, the Health Research and Educational Trust evaluated the first phase of its Community Care Network demonstration project.
Community Care Network was established in 1995 by the Health Research and Educational Trust in collaboration with the Catholic Health Association and the Voluntary Hospitals of America (now VHA).
It developed local networks in which health care providers collaborate with public health agencies, schools, businesses and other voluntary community organizations to address a comprehensive range of community health needs.
Twenty-five existing community partnerships from 20 states were selected through a competitive process to develop local care networks.
Each partnership received modest "seed money" designed to leverage existing community capacities and resources rather than underwriting new programmatic efforts.
The evaluation found that:
- The sites undertook 593 action steps that were part of 152 different initiatives. Half of the action steps were completed.
- 15 of the 25 Community Care Network sites had expanded their provider network, with nine reporting reductions in access barriers—eight of those in access for the underserved.
- Six sites increased primary care access and five expanded the scope of service in their communities.
- None of the sites had documented either a significant decline in community costs per capita or even a drop in the rate of increase in the costs of health and human services in the community.
- There was some evidence of improvements in health status in a few communities, e.g., measurement systems for teen pregnancy and immunization rates; increased cancer screening; and reduction in the rate of premature birth.
- The characteristics distinguishing the five top-performing sites from the bottom five sites were the ability to:
- Manage size and diversity.
- Attract and rely on multiple components of leadership.
- Maintain focus.
- Manage and channel conflict.
- Recognize life cycles and "hand off the baton."
- "Patch," defined as the ability to reposition assets, competencies and resources to address changing needs and priorities.