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Sponsored by: Healthy Living for ME
June 21, 2023

Healthy Living for ME® — Maine’s Community Care Hub

Gerard Queally, Managing Partner, Healthy Living for ME

Growing national research on the social determinants of health suggests that access to quality health care contributes only 20% to an individual’s overall health and well-being, while social risk factors, behaviors, and physical environment contribute 80%. All Mainers should have the opportunity to attain their full health potential, regardless of their circumstances. This is the very definition of health equity! While medical providers manage the clinical, physical, and mental health complexities of patients with multiple chronic conditions, these same patients struggle to navigate the intricate array of community-based services that they need in order to thrive in their communities. To address these challenges, Healthy Living for ME® (HL4ME®) is emerging as Maine’s Community Care Hub, building a bridge between healthcare and a network of existing and growing community-based organizations.

Q. What is the history of HL4ME?

HL4ME was founded in 2016 as a joint venture between Aroostook Area Agency on Aging, SeniorsPlus, and Spectrum Generations. Its initial focus was on health promotion and disease prevention by expanding the access to and availability of evidence-based programming for falls prevention and chronic disease self-management education (i.e., “Matter of Balance, Living well with Chronic Pain, and National Diabetes Prevention Program,” etc.). Since its inception, over 5,500 people have participated in its programs - coaching and classes - through a network of 25 partners. In 2022, HL4ME received funding from the Administration on Community Living (ACL) to begin development as a Community Care Hub.

Q. What is a Community Care Hub and what is the principal service it provides?

A: As a Community Care Hub, HL4ME coordinates and integrates healthcare (hospitals, insurers, healthcare systems, etc.) with community-based organizations (CBOs). This administrative approach achieves operational efficiency, effectiveness, and economies of scale inherent in an organized network delivery model. HL4ME networks and integrates CBO activities and missions with healthcare, thereby making them more effective in serving the people of Maine. HL4ME offers Health Promotion and Disease Prevention via a statewide network of facilitators/leaders at local CBOs for in-person and virtual coaching. Through contracts with healthcare entities, HL4ME provides short- and long-term social care coordination for Mainers who have been identified or have self-identified as needing specialized and closely managed support and community service navigation assistance. In 2022, HL4ME assisted 856 patients in social care coordination.

Q. What challenges is HL4ME experiencing?

A: The Community Care Hub concept has the support of the Centers for Medicare and Medicaid Services (CMS) and the ACL. HL4ME must demonstrate its value to health plans by reducing their costs, to health systems by improving the outcomes of their patients, and to CBOs by enabling access to their services. To that end, HL4ME is seeking funding to purchase and implement a closed-loop Social Health Access Referral Platform that will allow HL4ME to improve CBO data systems and service delivery coordination. Most importantly, HL4ME must improve patient health and well-being as Maine’s Community Care Hub.

Q. Does the ruralness of Maine adversely impact access to healthcare?

A: Absolutely, but it does not need to be an insurmountable barrier! Maine residents will benefit from improved equity of access and delivery of community-based social services to rural and remote areas. In February 2023, HL4ME, as the executive sponsor, with MaineGeneral Medical Center, HealthReach FQHC, and 13 CBOs formed a community health partnership. This partnership was awarded a Rural Community Health Improvement Project planning grant with the goal of improving rural health in Somerset and Kennebec Counties. By exploring a variety of service delivery models, including the Community Care Hub, it is expected the partnership will find future statewide solutions that address the healthcare disparities in rural Maine.

Q. How will you measure success for HL4ME?

A: HL4ME is a fledgling Community Care Hub, so there is still much work to be completed before success can be declared. I would measure success in two ways: one, HL4ME must be sustainable as its own independent 501(c)3 non-profit organization. Currently it is incubated under Spectrum Generations as we develop infrastructure and value. With the proper blended and sustainable revenue streams, HL4ME must eventually separate and independently network Maine’s CBOs for the benefit of all. Two, HL4ME improves the health and wellness of the people of Maine and teaches people how to manage their health and navigate the robust but complex existing social service network.