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Upstream Healthcare Delivery

The clinical manifestations we see as healthcare providers are downstream consequences, or trickle-down effects of upstream structural barriers, that manifest as cyclical instability, high rates of healthcare system utilization, and persistent health disparity statistics with predictable demographic stratification. We work in partnership with our patients to identify the root causes of disease instability and remove the barriers to health, wellness, and thriving. Drivers of persistent unstable health can be rooted in social causes such as housing, education, employment, and even lack of access to social interaction.

Focusing on upstream social determinants of health we are able to address structural barriers and prevent downstream effects they cause. We are collaborating with community partners and other unique entities to create sustainable and inclusive economies using intentional strategies in hiring, investing and purchasing. These efforts lead to creating vibrant economic communities that positively impact health and wellness in the broadest sense.

BMC Leadership

Partnerships and Advocacy

We are proud to partner with our colleagues at healthcare organizations locally and across the country to advance the importance of using an upstream approach address social determinants of health barriers by sharing our best practices and expertise and also learning from our peers. In Boston Healthcare systems who are ACOs formed a SDOH Collaborative one year ago. We are working together to foster shared education, evolution and group support to achieve success in this new era of healthcare. Learn more about our participation in the following organizations:

Center for Community Investment

The Center for Community Investment (CCI) works to strengthen the capacity of the community investment system to improve the lives of low-income people. Through a combination of technical assistance, leadership development, dissemination of research and lessons learned, and the creation of a robust peer network, the Center builds the capacity of local institutions and partnerships to define priorities and guide capital and other resources to advance the social, economic, and environmental interests of marginalized communities.

In February of 2018, CCI launched an initiative, Accelerating Investments for Health Communities, to help innovative hospitals and health systems accelerate and deepen efforts to invest in their communities and inspire others to do the same. BMC is proud to be one of the nine nonprofit hospitals and health systems participating in the initiative, which is supported by the Robert Wood Johnson Foundation.

Healthcare Anchor Network

Boston Medical Center is a proud member of the Healthcare Anchor Network. Made up of more than 30 healthcare systems across the US, the Network works to build more inclusive and sustainable local economies to more rapidly impact social determinants of health.

The Network has three main inclusion strategies: hiring, purchasing, and investing. At BMC, we meet all three of these through our recent investment in housing. For example, we have invested in the Bartlett Place development which will have mixed and affordable housing and a contractor hiring women and minorities from the community as laborers. We’ve also made a no-interest loan and provided subsidies to bring a supermarket to that community which will, in turn, hire from the community including from the re-entry population, provide a career track in the food industry to its employees, and purchase much of its food locally.

In addition, the Network provides BMC the opportunity to formally collaborate with and learn from like-minded health care systems, share solutions, and develop and execute new ideas together.

New Models of Care

BMC and our health system are significant participants in the state of Massachusetts’ reform of its Medicaid program, MassHealth.