Partnerships and Performance: The Role of Health Care and Social Service Networks in Reducing Utilization and Costs for Older Adults with Complex Needs


Social services play an essential role in improving health outcomes at reasonable cost for high‐need, high‐cost populations. While health care organizations are beginning to understand the value of working collaboratively with social service providers, they lack knowledge of best practices for structuring and cultivating such collaborations at the community level. Building on her current Commonwealth Fund–supported work, Yale’s Elizabeth Bradley will undertake an examination of provider network characteristics and strategies associated with high‐performing communities—health service areas with comparatively low rates of avoidable health service utilization and low costs—and those associated with low‐performing communities. The project team will examine: the composition of provider networks (diversity and participation); how ties between health and social service organizations are structured; the role of social capital; and provider interactions that support older adults with complex care needs. The study will use network analysis software and will be informed by a survey of 250 representatives of health care organizations and social service agencies in 20 diverse U.S. communities. The survey instrument will collect information on interorganizational ties as well as implementation of strategies for linking health and social services. Findings from this innovative study will provide health system leaders, social service agencies, and state and federal policymakers with practical guidance for improving integrated care for high‐need, high‐cost populations. Through its application of an analytical method used in other disciplines to health care delivery, the project could also enhance the field of health services research.

Grant Details

Grantee Organization:
Yale University
Principal Investigator:
Elizabeth Bradley, Ph.D.
Award Amount:
Approval Date:
November 8, 2016

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