Session: Understanding Health Care Reform: Social Work Research on Integrated Health (Society for Social Work and Research 21st Annual Conference - Ensure Healthy Development for all Youth)

As health care reform gains momentum, we are seeing a transformation in health care delivery which has profound implications for social workers and other health care providers.  Integrated health care, a key strategy to target poor outcomes among people with complex health and mental health needs and the overall fragmentation of care, is now shaping the delivery of primary care and behavioral health.  Integrated health care models, such as patient-centered medical homes and Accountable Care Organizations, and financing mechanisms that incentivize quality over volume and provide infrastructure support for the coordination of care are now being implemented. To be successful, these system level changes must be supported by clinical integration meaning that providers, including social workers, need to acquire new skills and roles.         

Health care reform provides a unique opportunity for social work researchers, who play a prominent role in implementation research, to examine the adoption of new interventions and practices related to integrated health care.  With our focus on the social determinants of health and disparities, practice interventions related to engagement and activation, and the delivery of person-centered care, social work researchers can make an important contribution to the evidence base. There are funding opportunities for this type of research from the National Institutes of Health and the Person Centered Outcomes Research Institute, which was created by the Affordable Care Act. The papers in this symposium present examples of social work research on integrated health care. They focus on two aspects of health care reform:  the education and training of providers and the development and evaluation of integrated health care interventions. 

Paper #1 will highlight workforce needs, by comparing the geographical locations that have received Health Resources and Services Administration funding to train social workers in health care reform to locations where states have opted to expand Medicaid.  Paper #2 will also focus on workforce issues by examining which community mental health clinics have sought training in health care reform and what types of training they have pursued. Paper #3 tests the feasibility, acceptability and initial impact of a health care intervention for Latinos in behavioral health settings, in terms of activation, perceived quality of care and receipt of preventive primary care. Paper #4 explores the use of “practice” coaches to improve provider delivery of integrated care from the perspective of leaders and coaches.

The papers demonstrate a variety of methodological approaches that can be utilized when conducting research on integrated health care, including primary and secondary data analysis and quantitative and qualitative approaches. Demonstrating the multilevel perspective of implementation research, these papers utilize different units of analysis, ranging from analyzing particular states and organizations to providers and service users in health care settings. Together these papers highlight the potential for social work research to contribute to the knowledge base on the effectiveness and implementation of health care reform initiatives.