Factors Associated With Contracting Between Area Agencies on Aging and Health Care Entities.

Contracting with health care entities offers an avenue for Area Agencies on Aging (AAAs) to be reimbursed for providing services that improve health and avoid the need for expensive health care among older adults. However, we have little systematic evidence about the organizational characteristics and policy environments that facilitate these contractual relationships. Using survey data on AAAs from 2017-18, we found that contracting with health insurers was significantly more likely if AAAs had strong business capabilities and access to a state CBO contracting network. AAA contracting with health care delivery organizations trended with different factors, becoming more likely if states had implemented more integrated health care delivery programs, and becoming less likely if states had managed long-term services and supports. Contracting could be facilitated by supports for AAA business capabilities, as well as state policies that increase demand for their services among health insurers and health care delivery organizations.

How Do Area Agencies on Aging Build Partnerships With Health Care Organizations?

BACKGROUND AND OBJECTIVES: Partnerships between health care and social service organizations may contribute to lower health care use and spending. Such partnerships are increasing, including Area Agencies on Aging (AAAs) working and contracting with health care organizations. Nevertheless, knowledge about how AAAs establish and manage successful collaborations is limited. We sought to understand how AAAs establish and manage partnerships with health care organizations. RESEARCH DESIGN AND METHODS: We conducted an explanatory sequential mixed-methods study using a positive deviance approach. We used national-level data to identify AAAs with multiple health care partners serving areas with low utilization of nursing homes by residents with low-care needs (n = 9) and AAAs with few health care partners and high utilization for comparison (n = 3). We conducted in-depth interviews with key informants from these 12 AAAs and their partner organizations (total n = 130). A 5-person multidisciplinary team used the constant comparative method of analysis, supported by Atlas.ti software. RESULTS: Highly partnered AAAs were characterized by 3 distinctive features of organizational culture: (a) attention to external environments, (b) openness to innovation and change, and (c) risk-taking to learn, improve, and grow. AAAs and partners describe a broad set of organizational strategies and partnership development tactics, depending on their local contexts. These features were underdeveloped in AAAs with few health care partnerships. DISCUSSION AND IMPLICATIONS: While federal and state policies can create more favorable environments for AAA-health care partnerships, AAAs can also work internally to foster an organizational culture that allows them to thrive in dynamic and challenging environments.