WESTERN NEW YORK INTEGRATED CARE COLLABORATIVE

Western New York Integrated Care Collaborative (WNYICC) is a Community Care Hub with 25 health plan contracts designed to deliver programs to 15 counties in western New York by their more than 50 network members. WNYICC partners with Independent Health to address health-related social needs through interventions such as meals, medical nutrition therapy, diabetes prevention and diabetes self-management programs, Healthy IDEAS and coaching programs. Their coaching programs (Community Health Coaching, Falls Prevention and Caregiver Support), include program-specific assessments, referrals to evidence-based programs, care coordination, and billing and coding to pay for these programs. WYNICC subcontracts with 16 agencies to deliver these programs. Integrating members’ clinical care with social care is a priority of WNYICC’s programs.

RUNNERS UP

Runners up for The John A. Hartford Foundation 2023 Business Innovation Award are Central Ohio Area Agency on Aging in Columbus, OH, which was recognized for creating a simplified tool that allows Community Health Workers, social workers and registered nurses screen patients for health-related social needs through its Social Determinant of Health Accelerator Program. Region IV Area Agency on Aging in St. Joseph, MI was recognized for its partnership with Corewell Health South and a network of community-based organizations to help reduce the frequency of emergency department visits among older adults by using interventions that apply the 4Ms framework to patient care.

Read the press release to learn more about the 2023 winners.

DIRECTION HOME AGING & DISABILITIES

Direction Home Aging & Disabilities (DHAD), located in Uniontown, Ohio, is an Area Agency on Aging that provides care management and care transitions to various populations across the lifespan. This award honors the contract between Medical Mutual of Ohio (MMO) and the 12 AAAs in Ohio with DHAD serving as Network Lead. Focused on acute care transitions, over four years the contract has expanded to multiple services and multiple populations within MMO’s membership. Annually, this program serves over 3100 members across Ohio through home & telephonic visits, medication reconciliation and medication discrepancy resolution.

MMO recognized Ohio AAAs for reducing 30-day hospital readmissions to below 9 percent for program participants, but even more importantly, as part of the solution that helped them to achieve their 5-Star Medicare Advantage Plan rating by CMS. In honor of the AAAs work to reduce member readmissions, the Plan awarded an additional $50,000 to the Ohio Association of Area Agencies on Aging, which will establish additional innovation and business opportunities for Ohio’s AAAs.

RUNNERS UP

Runners-up were the Maryland Living Well Center of Excellence–MAC, Inc. in Salisbury, MD and Mid-America Regional Council in Kansas City, MO. This award recognizes community-based organizations that have made significant strides in contracting with health care entities and, as such, have substantially improved the quality of life of older adults.

Read the press release to learn more about the 2022 winners.

Hebrew SeniorLife, Inc.

Hebrew SeniorLife, Inc. (HSL) was awarded The John A. Hartford Foundation Business Innovation Award for their innovative Right Care, Right Place, Right Time: Effectively Integrating Senior Care and Housing (R3) program which integrates housing and health care by embedding a nurse and a social worker in senior housing. The program helps meet the holistic needs of older adults by conducting routine assessments, providing care coordination and measuring outcomes. HSL's partnership serves as a model for care that could shape the way housing and health care are paid for locally and nationally.

Runners Up

Runners up for The John A. Hartford Foundation 2021 Business Innovation Award are DayBreak Adult Care Centers in Oakland, CA, which was recognized for its Rapid Response Case Management program, and Area Agency on Aging and Disabilities of Southwest Washington in Vancouver, WA, which was recognized for its Community Paramedicine program.

Read the press release to learn more about the 2021 winners.

JASA

JASA received the 2020 award for its home-based care transitions program, which targets older adults who are eligible for both Medicare and Medicaid or who are uninsured. Through this program, JASA addresses the social determinants of health, such as access to healthy food, reliable transportation and adequate housing, in order to reduce hospital readmission rates and improve the overall health and well-being of program participants. By developing partnerships with local hospitals, JASA has found an innovative way to enable healthy aging at home and in the community, where most older adults prefer to be.

Runners Up

Runners up for The John A. Hartford Foundation 2020 Business Innovation Award are Homage in Lynnwood, WA for its case management program, Lifespan of Greater Rochester in Rochester, NY for its Community Care Connections Program, and The Independence Center in Colorado Springs, CO.

Read the press release to learn more about the 2020 winners.

The Institute on Aging

The Institute on Aging was recognized for its pioneering work in helping older adults transition from institutional settings into the community where they can live independently and with dignity. The Community Care Settings Pilot Program takes a person-centered approach to transitioning older adults away from institutional settings and into their own homes by providing a network of partners that supply case management and community supports. The program, which boasts a 93 percent success rate, has resulted in significant health care cost savings, and has been replicated across California counties with new health plans.

Runners up

The 2019 Business Innovation Award also recognized Appalachian Agency for Senior Citizens for its work developing a rural Program for All-Inclusive Care for the Elderly. Also recognized was the Camarillo Health Care District, for its health care contracting work related to post-acute care, case management and self-management.

Read the press release to learn more about the 2019 recipients.

Coalition of Limited English Speaking Elderly

The Coalition of Limited English Speaking Elderly (CLESE) was recognized for the innovative partnerships it developed to help older adults who have limited English-speaking skills communicate effectively with their health care providers. CLESE’s partnerships with Illinois health plans allow them to provide interpretation services and care coordination assistance through their network of more than 50 ethnic, community-based member organizations, including Area Agencies on Aging.

RUNNERS UP

The John A. Hartford Foundation 2018 Business Innovation Award also recognized Area Agency on Aging, Region One for its work partnering with a local long-term care Medicaid provider to provide care transitions, licensed behavioral health and acute care services. Also recognized was the New York City Department for the Aging for its partnership with OneCity Health Services to improve care transitions and reduce hospitalization rates.

Read the press release to learn more about the 2018 recipients.

The Virginia Area Agencies on Aging–Caring for the Commonwealth

The Virginia Area Agencies on Aging–Caring for the Commonwealth (VAAACares) received The John A. Hartford Foundation 2017 Business Innovation Award in recognition of its development of a statewide service delivery system that enabled more efficient contracting with duals plans and managed care organizations. Through VAAACares, Virginia’s network of Area Agency on Aging (AAAs) positioned themselves for business expansion through additional contracts with insurers and health care providers, leveraging the important role AAAs play in reducing health care costs and improving quality of life through client empowerment and services provided in the home.

Runners Up

The John A. Hartford Foundation 2017 Business Innovation Award also recognized Living Well Center of Excellence, which is administered by Maintaining Active Citizens, Inc., for its partnerships with hospitals and other CBOs to spread evidence-based chronic disease self-management programs throughout the state of Maryland. Also recognized was the Aroostook Agency on Aging for its work partnering with health care organizations in Maine to close coverage gaps in service to older adults.

Read the press release to learn more about the 2017 recipients.

Southern Maine Agency on Aging

The Southern Maine Agency on Aging (SMAA), the inaugural recipient of The John A. Hartford Foundation Business Innovation Award, was recognized for its bold, transformative work to improve the quality of life for older adults and people with disabilities. Through a sustainable business partnership with the Maine Health Accountable Care Organization (ACO), the agency delivered high-quality community-based programs such as Chronic Disease Self-Management, A Matter of Balance and Simply Delivered Meals.

Runners up

Runners up to for The John A. Hartford Foundation 2016 Business Innovation Award include the County of San Diego Aging and Independence Services and the Aging & In-Home Services of Northeast Indiana, Inc for their innovative work improving health outcomes and the well-being of older adults and people with disabilities in their communities.

Read the press release to learn more about the 2016 recipients.