Griffin Health chosen to pilot social care coordination network Unite Connecticut

Griffin Hospital will be one of the first hospitals in Connecticut to launch Unite Connecticut — a statewide initiative of the Connecticut Hospital Association that connects health and social services providers through a shared technology platform to address social needs and deliver integrated care.

Through Unite Connecticut, Griffin is able to screen and refer patients to community-based organizations for needs such as housing, food, transportation, and employment, effectively addressing social needs on an individual level.

This system will be a tremendous help in addressing social determinants that effect the health of Lower Naugatuck Valley residents, and a valuable tool for Griffin’s efforts to improve the health of the population and lower the cost of care, which is a tremendous burden to consumers, employers that provide employee health insurance coverage, and both the state and federal government.

“Griffin Health and the Valley’s local community-based organizations are an ideal setting to test the capabilities and effectiveness of Unite Connecticut,” said Griffin Hospital President and CEO Patrick Charmel. “As the beneficiary of a multi-year Accountable Heath Communities federal grant that funds a robust screening effort in Griffin’s Emergency Department, Childbirth Center and Griffin Faculty Physicians’ primary care offices, we have been able to define some of the obstacles to good health in our communities and partner with local support agencies to overcome these deterrents. We firmly believe that what we are attempting to build in the Valley and throughout Connecticut can serve as a national model for improving the country’s healthcare system.”

The five-year Accountable Health Communities (AHC) grant tests whether systematically identifying and addressing the health-related social needs of the Medicare and Medicaid beneficiaries in the community impacts health care quality, utilization and costs. Since August 2018, Griffin has screened more than 4,000 individuals. Approximately 30 percent of those screened stated that they do not have enough food and another 10 percent stated housing and/or transportation needs.

In just the first few days of using the Unite Connecticut platform, Griffin has made more than a dozen referrals to help individuals access the community resources they need. Most of the referrals have been to TEAM Inc., a not-for-profit human services agency that assists the Naugatuck Valley and surrounding areas, for help with meals, caregiver assistance, utilities or transportation.

“TEAM is proud to partner with the region of community based organizations and Griffin Health as we collectively pilot the Unite Connecticut platform,” said TEAM Inc. President and CEO David Morgan. “Just days into the piloted launch of Unite Connecticut, TEAM is already witnessing firsthand the meaningfully coordinated care and communication across healthcare and social services within Griffin Health’s region. Health and social outcomes are highly interrelated, and Unite Connecticut provides an exceptional blueprint going forward as we comprehensively address this work across diverse health and human services industries.”

In addition to the findings of the AHC screenings, the 2019 Valley Community Index showed that the Valley’s population has a lower life expectancy compared to the statewide average. Lung cancer, heart disease, and drug-related deaths affect the region’s lower life expectancy, while chronic diseases such as diabetes, heart disease, chronic obstructive pulmonary disease (COPD), and asthma are among the most common causes for hospitalization and emergency department visits.

Unite Connecticut will assist Griffin in connecting patients diagnosed with these conditions to health education and disease management programs.

“We are delighted to work with Unite Connecticut as the social referral platform at Griffin Health Services,” said Monica Oris, director of Population Health at Griffin. “We have a robust group of community-based organizations that are eager to partner with us to better manage the health and well-being of the clients we mutually serve.”

Unite Connecticut will not only help Griffin connect patients to social support service providers that can manage their social needs, it will also provide real time information about whether individuals are following-up and utilizing the services,” Oris said. “Additionally, the system will allow Griffin to gain knowledge on what agencies are best equipped to meet the needs of community members. “This is an innovative way to direct our patients to the services they need and assess which of these services can best impact their overall health and wellbeing.”

Unite Connecticut was initiated earlier this year through a partnership between the Connecticut Hospital Association and Unite Us, an outcome-focused technology company that builds coordinated care networks. Through this work, hospitals and health systems are identifying and addressing social determinants of health as part of their population health improvement efforts. “We applaud Connecticut hospitals and health systems, along with community-based organizations, as they implement Unite Connecticut,” said Jennifer Jackson, CEO, CHA. “This effort will improve patients’ lives by ensuring that their social needs are met, and it will transform healthcare and keep our communities healthier.”

“We are thrilled to collaborate with Griffin to build integrated networks that comprehensively address people’s needs and will transform care delivery in Connecticut,” said Steve Strauss, Head of Network Development for Unite Us. “The Unite Us team will work hand-in-hand with Griffin Hospital, affiliated partners and community-based organizations, before, during and after launch to ensure the network’s integrity and success,” he added.

The Unite Connecticut rollout will continue at hospitals and health systems across the state through 2021, and includes a resource database that leverages the work of 211 Connecticut, a program of the United Way of Connecticut, as part of the statewide network.