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HSTRC Grantees

HSTRC is supporting a multiyear initiative to bring together relevant research, consider the merits of various models, and identify gaps in evidence. Grantee projects are highlighted in this section.

Advancing an Equitable Telehealth Delivery Model for Medicaid-Eligible Populations with Chronic Conditions at Federally Qualified Health Centers​
Research Model The equity-focused and primary care-based telehealth delivery model within a large Medicaid ACO comprised of Federally Qualified Health Centers (FQHCs) will help to address full range of medical, behavioral, and social needs, and invests in telehealth capacity, training, and infrastructure at FQHCs in Massachusetts. Evaluation Approach The goal of this project is to... Read more »
Advancing Equitable Models of Care for Medicaid-Eligible Children Served by Head Start Programs: Implementation and Evaluation of Telehealth Services​
Research Model The study will evaluate a telehealth service delivery model for rural Head Start (HS) programs serving culturally and linguistically diverse children. The goal is to improve access and reduce disparities for Medicaid-eligible populations within rural communities, and to develop a sustainable Medicaid finance model. Evaluation Approach A mixed-methods, randomized control trial design will... Read more »
Building Relationships Into Care Delivery to Grow Equity (BRIDGE)​
Research Model The “Relationship-Based Care Model” leverages care team coordinators (CTCs) to serve as patient liaison, guide, coordinator, and coach throughout the care experience, and measure whether this relationship-based care model leads to improved care. Evaluation Approach The goal of this project is to compare and contrast the referral use and outcomes, and patient-level use... Read more »

Equitably Assessing the Impact of a Coordinated, Multidisciplinary Diabetes Care Model using Implementation Science and Participatory Approaches ​
Research Model The program targets low-income, Medicaid-eligible individuals with prediabetes, diabetes, and other endocrine disorders and provide care through a coordinated, multidisciplinary team that includes Clinical team (clinical care, education and support), Pharmacy team (medication decisions, adherence), Social Workers, CHWs, Navigators (address social and emotional needs), and Data Analytics team (risk stratification and patient technology).... Read more »
HOPE: Housing as an Opportunity to Promote health Equity: A Housing and Integrated Health Model of Care​
Research Model The “Housing and Integrated Health Models of Care” model of care applies a Risk Stratification Management Tool to prioritize persons experiencing homelessness (PEH) for housing, while at the same time aligning the delivery of Integrated Health services. At the conclusion of the project, the grantees will have a standardized framework, tools, and protocols... Read more »
Impact of a New Street Crisis Response Team on Service Use Among San Francisco’s Homeless Population with Mental and Substance Use Disorders​
Research Model The San Francisco Crisis Response Team (SCRT) is dispatched by 911 and provide real-time response in public spaces to provide support in paramedics and behavioral health to Medicaid-eligible adults experiencing homelessness in mental health and/or substance use crisis. Evaluation Approach An interrupted time series design will be used to measure key impact on... Read more »

Social Determinants of Health Treatment as an Essential Structural Change in Primary Care​
Research Model The research model integrates siloed systems of care, promoting a culture of understanding poverty as an environmentally based condition and provides evidenced-based treatment of social determinants of health (poverty treatment) integrated into a system that traditionally focuses on treatment of physical and behavioral health. Evaluation Approach The goal of this project is to... Read more »
The Dose of the Web of Well-Being with Integrated Clinical Case Management to Reduce Inequities in Value in a Medicaid Population​
Research Model The relational and longitudinal Intensive Clinical Case Management model will have system-level integration and will include individuals with high complexity health conditions and any mental health disorder with caseloads of 30:1 maximum. Evaluation Approach The goal of this project is to  understand unplanned care and total cost of care. Contribution to HSTRC’s Research... Read more »
The Impact of Telehealth Access on Health Equity for Patients, Families, and Community Members in Two Medicaid-Focused Pediatric Primary Care Models​
Research Model Telehealth was understudied in pediatrics prior to COVID-19, particularly among Medicaid-insured children who had little access. Using multidisciplinary models, the project will compare telehealth programs at Harriet Lane Clinic and Children’s Medical Practice and identify qualitative themes to refine models of care. Evaluation Approach Qualitative interviews will help understand patient/family and stakeholder insights... Read more »