About the Project

In July 2019, the Robert Wood Johnson Foundation (RWJF) funded Avalere to establish the Health Systems Transformation Research Coordinating Center (HSTRC). In collaboration with researchers, policymakers, and health system leaders, the HSTRC reviews relevant research, assesses health system models’ ability to advance equity, and identifies gaps in the evidence base to change the ways in which research is generated, funded, and used to promote health equity for Medicaid-eligible individuals. As it currently stands, HSTRC is the only coordinating center in the country that brings together relevant research and considers the merits of various care models for Medicaid-eligible individuals.

HSTRC Conceptual Framework

Goal: Promoting Health Equity for Medicaid-Eligible Populations

Literature Search Key Takeaways

Between July and December 2019, Avalere conducted a targeted white and grey literature search using a variety of sources to assess the current state of how health systems address the interrelated goals and needs of Medicaid-eligible individuals. Findings and key takeaways from the literature search comprise this research directory that houses synthesized learnings from the environmental scan as well as emerging evidence.

Though the research directory features key takeaways for each source, several findings emerged as promising characteristics of models that address the interrelated goals and needs of Medicaid-eligible individuals, including:

  • Multidisciplinary care approach

    Successful models include a wide range of providers, including primary care, behavioral health, and community providers in interventions. These approaches may feature community-based providers, interdisciplinary care teams, or referrals to community-based organizations.

  • Screening for social needs

    Assessment forms or other screening tools can be used to identify social needs among potential model/program participants

  • Use of technology

    Successful models adeptly leverage technology (e.g., electronic health records (EHRs), electronic screening tools) to identify and track patients at social risk and patients’ unmet social needs, exchange data with community providers (to the extent possible), and deliver care (e.g., through telemedicine), when appropriate

  • Establishing and tracking metrics

    The strongest models identified metrics early in model implementation and tracked patient-centered outcomes internally as well as for evaluation purposes

Further research is needed to understand how to scale successful models, identify a more robust set of metrics that assess both clinical and social outcomes, and ensure robust and longitudinal evaluations. Research from the HSTRC grantees will help close gaps in knowledge and answer outstanding questions about scale and spread.

Progress To Date

Since HSTRC’s launch, we have completed several project milestones:

  • March 2020
    Launched the Research Collaborative

    We launched the Research Collaborative, which is intended to be a neutral, centralized management entity to coordinate funders, health systems leaders, and researchers to discuss how research can be used to transform health systems and advance health equity for Medicaid-eligible populations. The Research Collaborative’s goals and objectives are guided by a 12-member Advisory Board.

  • Summer 2020
    Published a Research Agenda

    Published a Research Agenda to strengthen the evidence around care models that address the interrelated goals and needs of Medicaid-eligible populations. The Research Agenda outlines: 1) priority components for health systems models of care addressing the needs and goals of Medicaid-eligible individuals, 2) HSTRC activities to support the implementation of the Research Agenda, and 3) Potential priority focus areas for grantmaking related to comprehensive system models of care and, as well as the resources and mechanisms that could facilitate long-term sustainability.

  • December 2020
    Distributed $2.7M in Funding

    Leveraging the Research Agenda, the HSTRC team distributed $2.7M in funding to 9 grantees that are conducting promising research that addresses evidence-based activities that could potentially be leveraged by external stakeholders. Grantee research is intended to evaluate the extent to which integrated health systems models of care are advancing health equity for the Medicaid-eligible populations they serve.

  • Summer 2021
    Developed a Communications Plan of Action

    Developed a Communications Plan of Action which outlines overarching goals, objectives, and specific tactics for disseminating learnings and key findings from HSTRC grantees to target stakeholder audiences.

    Initiated the Development of a Sustainability Plan

    Initiated the development of a Sustainability Plan which outlines milestones, potential funding and research partners, and reporting metrics to ensure that HSTRC work is sustained beyond 2022

  • Looking Ahead
    Upcoming Activities in 2022

    As HSTRC looks ahead to upcoming activities in 2022, our vision is to continue accelerating the spread of care delivery models that advance health equity for Medicaid-eligible populations. HSTRC will translate the work of grantees into actionable resources to spread their learnings to interested stakeholders who may be interested in leveraging these resources. This website will continually be updated on an ad-hoc basis as a central repository of relevant resources, compiling emerging evidence and grantee research progress. To sustain evidence generation beyond 2022, we intend to recruit additional funders to help sustain and spread the work that our HSTRC grantees are doing.

About HSTRC Grantees

As part of our mission to change the ways in which research is generated, funded, and used to transform health systems in promotion of broader health equity for Medicaid-eligible beneficiaries, we periodically fund research projects that fill key research gaps.

In August 2020, the Robert Wood Johnson Foundation released a call for proposals (CFP) to fund research on health systems models of care to better understand which model components are essential to promoting health equity. The CFP generated proposals that truly embraced the research agenda’s comprehensive approach to transforming health systems and promoting health equity. Avalere and RWJF selected 9 grantees, all of which will join the HSTRC Research Collaborative as it evolves and advances the research agenda. The grantees will add invaluable insights to the HSTRC research agenda and the broader goals around transforming care for Medicaid beneficiaries.