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Addressing Critical Resource Gaps in Our Community: the AHCM Project

In 2017, Rocky Mountain Health Plans (RMHP) and its provider-partners in Western Colorado began participating in the Accountable Health Communities Model (AHCM). RMHP partnered with QHN and CRN to create and administer the AHCM screener beginning in 2018. Although the Model is ending in April, providers can continue to screen using the AHCM screener.

The AHCM model set out to address critical resource gaps between providers, essential services, and community resources to improve health outcomes for people with social health needs, many who are hidden in plain sight.

At the project’s completion, over 100,000 total health needs screenings were completed, and just over 37,000 of the people screened were identified with needs ranging from food insecurity, housing insecurity, and quality, lack of transportation, help with heating, electric, and water bills to interpersonal violence and social isolation. Through this process, 5,000 of our community members with social-related health needs have opted into care navigation!

Because of this community’s commitment to care for the whole-person, we have made a huge impact in the lives of our patients.

Watch the video below for more!

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