How HHS is Shifting Gears From a Crisis Model to a Preventative One


Health and human services is a complex system of programs and services aimed at improving the well-being of individuals. Though traditionally two distinct systems of care, health and human services are merging as result of increased awareness surrounding the benefits of preventative care over crisis oriented care. Consequently, the one-size fits all model is being rejected in favor of whole-person, outcome-focused services. The American Public Human Services Association (APHSA) released the report, “Creating a Modern and Responsive Health and Human Services System” which addresses the need for transforming the nation’s health and human service infrastructure to make it more person-centered.

The report discusses how the nation’s public health and human services system is moving toward a modern, person-centered system designed to strengthen families and increase the overall health and well-being of all Americans. The initiative, “Pathways: The Opportunities Ahead for Human Services,” has become the road map for this transformation. The following are seven guideposts highlighted by this initiative:

  1. Person-and family-centered services designed to engage in meaningful ways with families up front, and which deliver the right services, at the right time, and for the right duration.
  2. Modern, efficient business solutions and customer connections that draw from the best innovations in government and the private sector.
  3. Data-reliant and evidence-informed programs that can achieve better, faster results, provide more targeted interventions, and reduce costs.
  4. Application of decades of research which improve the ways we engage and empower families.
  5. Accountability for sustainable outcomes, return on taxpayer investment and impacts that matter rather than for compliance with processes and outputs.
  6. Generative partnerships that bridge traditional divisions both within government agencies and across the public-private sections, and that leverage common resources and strengths.
  7. Widespread testing to spark innovations and prompt implementation of what works.

The principles outlined in the Pathways initiative have led to innovative strategies and methods which engage and empower families, advance information technology, and improve collaboration across sectors. For example, the Accountable Health Communities Model brings local governments, health providers, and nonprofit organizations together to coordinate care and improve the health of individuals and families. By addressing the social determinants of health up front, in addition to addressing primary care concerns, a sustainable model for improving the overall health of our communities can be attained.

In their report, APHSA outlines six ways to drive system transformation: leveraging integrated policy, maximizing modern platforms, creating space for innovation, investing in outcomes, applying science, and partnering for impact.

Leveraging Integrated Policy

There is a significant movement on both the state and federal level to remove conflicts and policy differences between programs and agencies and align them to the needs of modern families. Governments are creating policies that break down barriers to sharing data and are encouraging providers to address the social determinants of health. Some additional areas of focus for integrated policy are:

  • Use of population-based health data.
  • Adoption of two-generation/whole-family approaches.
  • A shared belief that employment is an engine to economic mobility.
  • Focused national attention on reducing youth and family violence.

Maximizing Modern Platforms

In order to successfully transform the health and human services system, there must be a sound infrastructure with strong technology and business processes. Outdated legacy systems and governance structures must be replaced with flexible technology that supports the latest business process reforms. Some important areas of focus on maximizing modern platforms are:

  • Application of advanced analytics to inform decision-making
  • Reuse opportunities in shared platforms and open data sources
  • Continued focus on interoperability and IT support for integrated health and human service systems

Creating Space for Innovation

The success of modernizing health and human services relies on discovering which innovations can best improve service delivery and business processes. Collaborative programs called “learning labs” provide an ideal environment for innovation. For example, the Center for Healthcare Strategies is funding multiple learning labs to test programs such as payment models, Medicaid accountable care organizations, delivery system and payment reform, and children’s health. In order to find innovative solutions there must be:

  • Increased grant opportunities designed to incentivize innovation and generate solutions
  • Re-purposing resources by all levels of government to spur innovation and create a cultural environment that encourages creativity and a safe space for testing new ideas

Investing in Outcomes

As part of the shift away from the reactive and crisis-oriented model for delivering health and support services, we must invest in a model that focuses on healthy outcomes. Identifying, scaling, and providing funding for innovations that promote this will ensure sustained and meaningful results. Data-driven reporting and predictive data analysis are important tools that drive improved outcomes for individuals and families. Success depends on:

  • Increased willingness to explore alternative financing mechanisms.
  • Bipartisan support for pay-for-success approaches.
  • Incentives aimed at increasing evidence-informed and evidence-based practices.
  • Application of rapid cycle experimentation and other modern research techniques that accelerate adoption of what works.

Partnering for Impact

Traditionally health and human service agencies have operated in their individual silos. In order to create a system that delivers person-centered care, agencies must establish new alliances and outcome-driven public-private partnerships. In addition, agencies must strive for:

  • Greater synchronization across public and private sector efforts.
  • Increased effort to leverage the expertise, reach, and efficiency of the nonprofit sector as well as the for-profit industry.
  • Application of collective impact strategies.

Health and human services are uniquely positioned to design new initiatives that can support healthier and stronger individuals, families, and communities. In order to accomplish this, states and localities must develop new and innovative service models that are evidence-informed and accountable. With a new presidential administration, there is much discussion around the transformation of health and human services. Despite the current uncertainty, we are encouraged to see states and communities across the nation develop community-wide initiatives to proactively improve the overall wellbeing of individuals and families. We will continue to keep a close eye on these policy discussions and various pilot programs around the country that are contributing to the transformation of our health and human services system.

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