In communities large and small across America, a myriad of solutions have emerged that expand access to health care, improve patient outcomes, and lead to better utilization of limited resources.  Much of this local innovation is being driven by community health collaboratives (CHCs), which develop coordinated systems of services that improve the quality of care and result in significant savings that can be reinvested into the system.  CHCs have been addressing the challenges of the current healthcare environment– often with limited funding and fanfare – by connecting medically-underserved people to needed health care services.

For nearly a decade, Communities Joined in Action (CJA) has helped harness the power of community health collaboratives as they build effective, efficient and sustainable systems of care for all.  CJA is a national membership organization of local and regional community health collaboratives.  Currently, CJA is approaching 200 members in 44 states that serve approximately 8.5 million low-income individuals.

By offering opportunities for dialogue and learning, CJA has helped mobilize and support community health collaboratives toward the shared vision of 100% Access and 0 Disparities.  CJA members have access to a diverse network of peer organizations, providing a vehicle to learn from other local efforts and adapt models with a demonstrated impact.

From 2000 through 2004, more than $400 million was invested through the U.S. Bureau of Primary Health Care’s Healthy Communities Access Program (HCAP) to help states develop community-level solutions that improved access to care for underserved populations.  CJA grew out of this national movement as a way to promote learning and collaboration among these communities. 

Community health collaboratives are aggregates of a number of health care entities, from hospitals, free clinics and community health centers to pharmacy assistance programs and public health departments.  These entities coordinate services to ensure that there is access to care for those who are medically underserved.  During the past decade, community health collaboratives have developed many successful programs that have significantly improved the health of their communities: 

• Community Health Works in Forsyth, Georgia has served nearly 4,000 low-income, uninsured residents since 2001.  The organization estimates that its clients use 40 percent less hospital care and 15 percent less emergency care than a national control group.
• Since 1996, Choice Regional Health Network in Olympia, Washington has enrolled as many as 17,000 residents in public programs or the Washington Basic Health Program, a state-sponsored program providing low-cost healthcare coverage through private health plans.  Not only does Choice have an exceptionally high rate of enrolling and retaining eligible adults, they have demonstrated a 20:1 return on investment for its member hospitals.
• Project Access in Wichita, Kansas enrolls low-income, uninsured residents when they seek care for a health problem and links them to a medical home for ongoing primary care.  The program leverages approximately $180,000 in administrative funding to generate $5 million worth of donated services each year.

As these examples show, not only do community health collaboratives improve access to care, they lower costs and enhance utilization of limited resources.  CJA has played a vital role in creating a national network of CHCs to facilitate the acceleration and dissemination of these best practices and other effective and innovative models, facilitating formal learning opportunities, and linking members joined in similar work across the nation.

Preparing for a New Wave of Local Innovation
The impact that the health reform law will have on community health collaboratives is not fully known.  However, under the provisions of the current legislation, it is likely that many more Americans will be newly covered, either through public or private insurance.  While this will enhance access to care, the need for community-based, collaborative strategies will remain.  In fact, the reform law includes incentives for healthcare providers to better coordinate care, reduce preventable hospital readmissions and help patients manage chronic disease – all activities that CHCs help to implement in their communities.

CJA is primed to play a role as a whole new wave of community innovation unfolds in response to the changes ahead.  Community health collaboratives are a fertile ground for strategies and solutions that address healthcare needs on a local level.  The implementation of the Affordable Care Act has vast implications for local delivery systems, community health improvement initiatives, and financing methods.  Exponential increases in the cost of health services and the nation’s current fiscal climate require bold action.  As this happens, CJA can provide a forum for disseminating emerging best practices and fostering dialogue among leaders on how community health collaboratives can design a sustainable platform that improves health and eliminates disparities by providing high quality care at lower costs and addressing the underlying causes of health problems in our increasingly diverse communities.

Administrative Home: Georgia Health Policy Center, 14 Marietta Street NW, Suite 221, Atlanta, GA 30303

Mailing Address: PMB 212, 1410 E. 4th St., Olympia, WA 98506-4632, Phone: 360.489.0496 info@cjaonline.net

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