Social determinants of health, including income, employment status, and access to healthy food and transportation, account for as much as 40 percent of individual health outcomes. Increasingly, states are recognizing the importance of interdisciplinary care teams and community linkages to address medical concerns as well as these social needs. These care teams can help achieve healthy outcomes, bend the cost curve, and improve patient satisfaction by extending care beyond the walls of a medical office. One specific model, community care teams (CCTs), is worth a closer look.
CCTs, also referred to as community health teams or interdisciplinary care teams, are locally based, multi-disciplinary groups of care providers. In contrast to traditional care teams that focus solely on patients’ clinical needs, CCTs address medical issues and the social determinants of health. CCTs assist with health management, facilitate communication between patients and providers, assess social and non-clinical barriers to health, and connect patients to appropriate treatment and other needed resources. While the structure of CCTs may vary by state and by community, CCTs generally incorporate a range of clinical and non-traditional health providers such as community health workers, peers, and navigators. The teams facilitate patient-centered health care and social service connections that are culturally appropriate, high-quality, and cost-effective.
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