Health plan-CBO partnerships

Community-based organizations (CBOs) focus on issues impacting the community such as healthcare, social services, education, and housing. Examples of CBOs include food banks, churches, youth mentoring programs, and neighborhood associations.¹

CBOs can help health plans with member engagement because CBOs are often important parts of the lives of community residents. The organizations are typically trusted by residents and can help guide people toward medical care or health insurance enrollment.

As such, health plans (and other healthcare stakeholders) are increasingly partnering with CBOs to support strategic goals and member health. However, the mechanics of CBO-health plan partnerships are often hazy, with unclear outcomes and impact. This is largely due to blurred understanding of responsibilities and poor tracking of engagement.

Currently, health plan and CBO collaborations are typically formed on an as-needed basis, with health plans engaging CBOs for specific initiatives or short-term projects. This is evident if you examine, most recently, the dynamics of the Medicaid unwinding. Health plans in the Medicaid sector relied heavily on partnership with CBOs to reach their members while conducting redeterminations. These partnerships were pivotal in spreading the message that redeterminations were occurring and helping members submit needed information to determine eligibility.² While some health plans benefited from established CBO relationships, other plans had to forge new partnerships to manage the challenges of the unwinding process.