Findhelp’s Colorado Health Solutions Summit

Creating better health outcomes for Colorado families is a top priority for state policymakers. Leaders across sectors are collaborating to identify trends, causes, and opportunities to enhance the health and well-being of our communities. Findhelp recently hosted a Colorado Health Solutions Summit at the Colorado Health Capitol in Denver, where we explored innovative approaches that are paving the way for transformation in closed-loop referral management. We were joined by leaders from government, healthcare, and nonprofit organizations to shape the future of health and social care for Colorado families.

Highlights from the 2024 Colorado Summit

This year’s summit focused on refining strategies to support vulnerable populations, expanding cross-sector partnerships, and integrating data-sharing initiatives. We had 27 participants from 15 organizations across the state, representing local and state government, health care, nonprofits, and more.

We’re grateful to the Colorado Health Solutions Summit participants for their contributions and invaluable insights in shaping these discussions. Below are some of the key themes and takeaways from a day of learning and sharing.

On data and funding

We explored the most critical metrics for defining SDoH work, highlighting the different perspectives and priorities of our four panelists. Participants also discussed the connections between data strategy and funding, acknowledging the current challenges while looking towards the future.

“I can talk a great talk – but it doesn’t mean anything if I can’t speak with the data. When you bring the data to the table, it’s a different conversation. When you meet with the people who don’t do the work every day, it’s the numbers that matter to them. We know these needs exist, but when we have that data, that’s when other people start to listen.”

Najwa Khalaf
Family Health Navigator Operations Manager | Children’s Hospital Colorado

On the Colorado Social Health Information Exchange (CoSHIE)

Findhelp is partnering with CoSHIE, a network to securely share physical, behavioral, and social health information between providers involved in whole-person care. CoSHIE is for people in Colorado who face barriers when navigating physical, behavioral, and social health care. It’s a network of social health data, insights, and resources that helps all people understand and access the best path to positive health outcomes.

Colorado’s SHIE approach is composed of both a statewide unifying architecture and regional hubs:

The statewide unifying architecture is the secure overarching network that will allow for the sharing of health information between providers.
The statewide organization will fund regional infrastructure and partnerships that are customizable to the priorities of the region. While some CoSHIE hubs may focus on substance use disorder, others may focus on homelessness.

Findhelp and CoSHIE: partnering to share data for impact and action

The CoSHIE and Findhelp partnership has the potential to assist existing (and future) Findhelp customers and partners in Colorado with consent management, identity resolution, and more. It will also provide a directory of community resources (powered by Findhelp).

On CBO partnerships

A resounding theme throughout the day, from all sides of the social care spectrum, was intentionality. There is value in deep, committed partnerships to maximize impact and increase funding opportunities. Partnerships take time and they take work. This is why Findhelp created Trusted Networks – tight-knit networks of priority partners that establish deep, long-term relationships which lead to better health outcomes for individuals in need.

Exploring new horizons

At Findhelp, we’re continuously adding and enhancing our functionality to support the next generation of social care work. At the Colorado Health Solutions Summit, we shared in our Product Roadmap session that our customers and CBO partners can:

Incorporate additional resource categories, like post-acute care facilities, into your Findhelp network.
Use member ingestion and search to pre-populate data and see eligibility. CBOs can document services provided and request reimbursement.
Collect codes across workflows to easily track outcomes and meet regulatory requirements.

Beyond the Summit: our work in Colorado

Our network spans the entire Centennial State and Coloradans across the state use the Findhelp platform to find and connect to needed services and support.

6,000+ listed programs serving Colorado
869,000 users statewide
3.2 million searches statewide
11,000+ social needs assessments completed on behalf of Coloradans

As of November 2024, Findhelp partners with more than 19 customers throughout the state to connect their patients, members, students, constituents, and clients to local resources. Our data and analytic tools can identify gaps in services and provide actionable insights to inform strategy and public policy.

Over the past two years, monthly users and searches on Findhelp’s network in Colorado increased 100% and 119% respectively, reflecting our important (and growing) role in connecting Coloradans to local social assistance.

Growth in searches in Colorado on Findhelp platforms, Q1 2021 through Q3 2024

Keep learning: join our nationwide community

Findhelp partners with customers and community organizations nationwide to collaborate on social care. There are many opportunities to join the movement and get involved – a couple of these are below!

Findhelp’s national Connect Summit | May 2025

Couldn’t attend our Colorado Health Solutions Summit? We’ve got you covered – save the date for our annual national Connect Summit on May 7 and 8, 2025. We’ll be releasing more information in January; in the meantime, sign up to receive updates!

Explore a Findhelp partnership

Chat with on of our expert team members to learn more about how we can partner with your organization to address social needs and improve health outcomes for the people you serve.

CMS SDoH Regulations for Hospitals are Finalized

Healthcare providers have increasing social determinants of health (SDoH) responsibilities as the Centers for Medicare & Medicaid Services (CMS) continues adding SDoH provisions in its annual rulemaking. In this week’s blog, we review what’s new for hospitals in 2025 under CMS’s Inpatient Prospective Payment System (IPPS) final rule.

Over the past several years, CMS SDoH provisions include the addition of screening measures, increased inpatient reimbursement for patients with certain needs, and introduced payment for SDoH assessment and community navigation. Findhelp is here to help you advance your health equity strategies. Use our platform and network to ensure that discharged patients are connected to the community resources they need.

To support our healthcare customers, Findhelp’s policy team closely monitors regulatory developments that impact your SDoH and health equity strategies. This also helps our community-based organization (CBO) network understand partnership opportunities and value propositions for the healthcare providers in their communities. Read on to learn more about the new IPPS provisions for 2025.

CMS SDoH Changes for Hospital Inpatient Settings

CMS’s Inpatient Prospective Payment System (IPPS) rule establishes hospital inpatient payment methodology, updates quality measures, and institutes other hospital programs. The 2025 final rule includes several new provisions that will further engage hospitals in SDoH work.

Increased reimbursement for services provided to people with housing insecurity

CMS increased the severity level designation for inpatient encounters with SDoH Z codes describing housing insecurity and inadequate housing.

Inpatient claims with these codes will have increased reimbursement to account for the increased costs of caring for people with housing concerns.
This change expands on the 2024 IPPS provision that increased the severity level designation for inpatient encounters with Z codes for homelessness.
Hospitals must ensure that the appropriate Z codes are included as a secondary diagnosis.

In the final rule, CMS encourages hospitals to include all SDoH-related Z codes on claims so that the agency can analyze whether social conditions affect the cost of care. Understanding this impact may prompt CMS to change severity levels for other SDoH-related Z codes, if appropriate. Staff can identify and document all SDoH concerns through screening discussions, and can use Findhelp to track post-discharge referrals. This creates safe and effective care transitions and can prevent readmissions penalties.

Age-Friendly Hospital measure added to quality reporting

CMS added an Age-Friendly Hospital structural measure to the hospital inpatient quality reporting (IQR). This means that hospitals will need to attest to having certain infrastructure and processes to meet the goals of the measure.

This measure assesses hospital commitment to improving care for patients older than 65.
Hospitals must attest that they have processes in place to assess for social vulnerability, including social isolation, economic insecurity, elder abuse, caregiver stress, and inadequate access to healthcare.
Positive screens should result in interventions and appropriate referrals.

Hospitals must begin reporting on this structural measure in calendar year 2025, which will impact fiscal year 2027 payments. Hospitals using Findhelp can easily attest to meeting this measure with embedded screening questions, tailored referrals, and a Trusted Network of CBO partners that is configured to meet the needs of older adults.

Mandatory payment model to incentivize quality improvement and care coordination

CMS finalized the Transforming Episode Accountability Model (TEAM), a five-year, mandatory payment model for hospitals in 188 geographic areas. The model begins in January 2026.

TEAM is a bundled payment model for certain joint, extremity, bowel, and heart procedures.
The model incentivizes the participating hospitals to reduce fragmentation and improve the transition from hospital to community for patients who undergo the relevant procedures.
TEAM includes health equity components like social risk adjustment in the payment methodology, health equity plans, and social needs screening.

CMS estimates that TEAM will save the Medicare program approximately $481M over five years. Participating hospitals can leverage Findhelp for social needs requirements and subsequent referrals.

SDoH items on long-term care hospital standardized patient assessment

CMS finalized the addition of SDoH questions on the standardized patient assessment required in Long Term Care Hospitals (LTCHs).

The LTCH standardized patient assessment must include the housing, food, utility, and transportation questions from the Accountable Health Communities tool.
This requirement is consistent with standardized patient assessment requirements in inpatient rehabilitation facilities. It also aligns with hospital IQR and inpatient psychiatric facility quality reporting requirements.

While CMS SDoH provisions fall short of requiring referrals for identified needs, the agency recommends referral pathways. Integrate Findhelp’s screening and referral processes into your LTCH EHRs to support simple workflows for closed-loop referrals.

CBOs Can Work with Hospitals to Offer SDoH Services

CBOs are essential partners, and well positioned to offer valuable services to hospitals that are required to identify and address patient social needs. As hospitals increasingly screen for SDoH, they’re identifying more needs and hospital staff often don’t know where to send patients for help. CBOs can build awareness of their services by:

Claiming your programs in the Findhelp network to ensure you receive referrals and connect with hospital partners.
Attending a virtual training to make the most of free Findhelp tools.
Partnering with Findhelp to establish contractual partnerships with hospitals that are looking to invest in SDoH interventions.

Partner With Us to Meet your Regulatory Requirements

Regulatory changes and requirements can become overwhelming, but Findhelp makes SDoH screening and referral workflows easy for customers. Connect with us to learn more about how we can partner to ensure people receive the SDoH services they need. Partnering with Findhelp will bring value to your patients and cost savings to your facility.

Social Care Networks Announced Under New York’s HRSN Waiver

New York State has announced its 9 Social Care Networks (SCNs), new entities tasked with managing social care delivery for people with Medicaid under the state’s Section 1115 health-related social needs (HRSN) waiver demonstration. Findhelp is proud to partner with several New York SCNs, providing interoperable and integrated technology that will fundamentally change HRSN service delivery in New York.

The SCNs will be a major part of the state’s HRSN service delivery infrastructure, implementing screening and navigation for the state’s Medicaid population, building CBO networks to deliver approved services, and paying their contracted partners for services.

About New York’s 1115 HRSN waiver

New York’s waiver, New York Health Equity Reform (NYHER), authorizes up to $3.16 billion for HRSN services and $500 million for HRSN infrastructure. The SCNs and Findhelp will be integral to the state’s infrastructure that is intended to integrate health and social care, and most closely knit the social safety net.

The HRSN demonstration requires the SCNs to:

Findhelp's New York network by the Numbers - New York's 1115 HRSN waiver

NYHER places a particular emphasis on HRSN screening for Medicaid members and coordinated service delivery. As such, interoperability is a cornerstone of this work. On behalf of our SCN partners, we will establish direct connectivity with New York’s health information exchange infrastructure and data warehouse to provide screening, referral, and service data for people who have consented to sharing. All data will be transmitted using HRSN data standards, enabling timely data exchange, reporting, and analysis.

“We are honored to have a role in New York’s transformational waiver program, and we applaud Governor Hochul, the New York State Department of Health, and the New York State Medicaid program for this investment. Findhelp is excited to move forward with our SCN partners and the CBOs in their networks to launch new models of social care that will improve the lives of New Yorkers with Medicaid.”
Carla Nelson
Sr. Director of Healthcare & Public Policy at Findhelp

Proud to partner with SOMOS Community Care, SCN for the Bronx

SOMOS Community Care is a network of over 2,600 culturally competent healthcare professionals who provide care to over 1 million patients in New York’s underserved neighborhoods—particularly Asian, African-American and Latino communities. Their network comprises primary care physicians, specialists, behavioral health providers, pharmacies, community-based organizations.

Their providers establish genuine relationships with their patients, getting to know their family circumstances, along with the social and environmental factors that impact their health. In a great many cases, SOMOS doctors work and live in the same neighborhoods as their patients, often sharing their linguistic and ethnic background.

As the designated SCN covering the Bronx for New York’s 1115 HRSN waiver, SOMOS will partner with Findhelp to further empower their CBO partners, create additional capacity around social needs screening, and deliver the state’s enhanced HRSN services to eligible populations.

Somos is excited to partner with FindHelp in this historic program to help New York’s most vulnerable populations. We have decades of experience working in underserved communities in a person-centered manner. This has allowed us to identify the barriers to wellbeing and inequitable situations our communities experience. We have for years strived to bring greater access to care and services, but our reach has been limited. This program, and working closely with FindHelp, will allow us to increase our reach, scale our efforts and more efficiently deliver care and services to those in need.
Lidia Virgil
Chief Operation Officer, SOMOS

A long history of supporting Bronx residents

Findhelp has been partnering with New York-serving organizations since 2015. We work with customers across the City, including many that provide services to the Bronx: Montefiore, the Institute for Family Health, Union Community Health Center, United Way of New York City, Mount Sinai, and more.

Over the past two years, the number of searches made by Bronx residents on the Findhelp platform has almost tripled, showing a growing need for community resources. Top needs in the Bronx are related to food and housing, with diapers & formula also high on the list.

Findhelp supports waiver programs across the country

Is your state preparing for a waiver to be approved? We’re ready to help. We have a history of successfully supporting 1115 programs. Connect with one of our expert team members to explore how Findhelp can support your implementation.

Partnering to Support Pennsylvania and Give CBOs a Seat at the Table

We are very proud to announce our partnership with the Community Action Association of Pennsylvania (CAAP) to lead community engagement efforts in support of the Pennsylvania Department of Human Services’ project to build a statewide online tool called PA Navigate. We’re partnering to support Pennsylvania.

Findhelp, CAAP, and CAAP member agencies are conducting outreach to local CBOs and onboard them to the PA Navigate platform.

CAAP will host local and regional listening sessions to ensure that CBOs are equal members of this collaborative effort to improve health outcomes for Pennsylvanians by addressing the social determinants of health (SDoH).

PA Navigate: a Platform for All Pennsylvanians

Built on the Findhelp closed-loop referral platform and network, PA Navigate (powered by Findhelp) is a statewide community information network, designed to address health and social care needs for Pennsylvanians by connecting them to community services.

In addition to Pennsylvanians using the platform to find help for themselves and their families, social service agencies, local nonprofits, community-based organizations, county and state agencies, and healthcare providers can also help make connections to services on behalf of individuals and track referral outcomes to ensure that people’s needs are met.

Partnering to Support Pennsylvania

Findhelp has partnered with the HIE Consortium members (Central PA Connect, ClinicalConnect HIE, HealthShare Exchange, and Keystone Health Information Exchange) to build and support PA Navigate. Consortium members will use the platform to assess the SDoH needs of Pennsylvanians and refer them to providers, with dignity and ease.

“We have built a strong relationship of trust with Pennsylvanians and are excited to work with our new partners to help more residents in need,” said Findhelp Founder and CEO Erine Gray. “Every member of the Consortium cares deeply about the people of the Commonwealth.”

Protecting Privacy

A key benefit of the PA Navigate platform (powered by Findhelp) will be its ability to allow healthcare providers to see the most complete view of an individual’s social care history and current status – to ensure Pennsylvanians are getting the help they need in the most efficient manner possible – while guarding their privacy and ensuring unrivaled protection of their personal information.

The Impact of Community Action Agencies

The federal Office of Community Services (part of the Administration for Children & Families, under the Health and Human Services Department) is celebrating May as Community Action Month in honor of 60 years of Community Action Agency (CAA) successes in reducing poverty, revitalizing communities, and empowering individuals and families. Read on to learn more about CAAs, their funding, and impact.

Community Services Block Grants

The Community Services Block Grant (CSBG) program, founded in 1964, combats the causes and consequences of poverty through Community Action. On average, CSBG serves more than 9 million individuals every year, in 99% of counties across the country.

CSBG provides direct federal funds to entities nationwide so that, informed by regular Community Needs Assessments, they can understand and address the unique needs of their community’s most vulnerable members.
Tribes, territories, and over 1,000 local Community Action Agencies provide CSBG-funded services and activities including housing, nutrition, utility, and transportation assistance; employment, education, and other income and asset building services; crisis and emergency services; and community asset building initiatives, among other things.
In FY 2022, $755 million was distributed to participating CSBG entities.

Supporting CAAs: the Community Action Association of Pennsylvania

The Community Action Association of Pennsylvania (CAAP) is the authority on addressing poverty in Pennsylvania and a statewide membership organization that represents CAAs in the Commonwealth.

CAAP is the primary source of advocacy, technical assistance, collaboration, and networking for Pennsylvania CAAs.
They represent 42 CAAs across the Commonwealth: public and nonprofit community-based organizations (CBOs) that serve all 67 counties in Pennsylvania.
While the approaches and programming is unique by Agency, all are unified in meeting the health-related social needs of their customers.

Partnering for Success in Pennsylvania

More than 1.5 million Pennsylvanians have already used Findhelp to connect with social care services. As of May 2024, we partner with 35 customers to connect their patients, members, students, constituents, and clients to resources. The PA Navigate initiative will bring an additional 100 participating provider entities to the Findhelp Pennsylvania Network.

Next Steps for PA Navigate & Pennsylvania

On January 23, 2024, PA Navigate introduced their public-facing website, pa-navigate.org, the first step in a multi-year project. Not only can individuals find help for themselves via the platform, but local nonprofits, healthcare organizations, state and county agencies, and community-based organizations can refer individuals. These agencies can also track the outcomes of these referrals to ensure individuals’ needs have been met.

Recently, Dr. Arkoosh, the Secretary of the Pennsylvania Department of Human Services (DHS) spoke at Findhelp’s annual user conference, Connect: a Social Care Summit. Gabe Roberts, the former Deputy Director and COO of TennCare (the State of Tennessee’s Medicaid Agency), interviewed Dr. Arkoosh for our opening keynote. She shared her experience with addressing health-related social needs through innovative Medicaid programs like 1115 waivers and social care reimbursement. Watch the interview below!

We Can Help Your Constituents

To learn how we can help you support your constituents, connect with our team.

Support Maternal Health by Addressing Social Determinants of Health

This week we’re taking a closer look at how social determinants of health (SDoH) impact health outcomes for pregnant women and new mothers, and how Findhelp is partnering with customers across industries and geographies to support maternal health.

Social Care Factors Impact the Maternal Health of Pregnant Women & Mothers

According to the U.S. Department of Health and Human Services’ Office on Women’s Health, around 1 in 5 women experience mental health issues during pregnancy or in the first year after giving birth.

Social care needs can increase this risk; it’s impossible to focus on all of the changes that come with being a new mom, including your mental health and wellbeing, when you’re worried about paying rent, buying diapers, or providing food for your family.

Our customers use Findhelp to connect pregnant women, mothers, and their children with social care resources that address their immediate needs, lower postpartum stress, and improve health outcomes.

Partnering to Support Maternal Health

The Findhelp platform includes multiple filters that users can apply to narrow their search results to programs that specialize in serving families, parents, mothers, and young children.

We partner with hospital systems, federally qualified health centers, payers, and more to support new parents. Here we highlight how a few of these organizations successfully partner and innovate with us to support pregnant women and mothers and improve health outcomes.

Massachusetts | City of Somerville’s “SomerBaby” Program

The City of Somerville is home to a diverse mix of 79,815 blue-collar families, young professionals, college students, and recent immigrants from a range of countries, including El Salvador, Haiti, and Brazil. One of the most ethnically-diverse cities in the U.S., more than 50 languages are spoken in Somerville Public Schools.

The Somerville Hub is a community effort originally intended for the early learning community and made possible by Early Learning Challenge Grant funding support from the Massachusetts Department of Early Education and Care.
Since 2017, the Hub has served youth of all ages and their families.

Partnering with Findhelp

In 2021, SomerPromise (part of the Somerville Health and Human Services department) expanded the Hub to include a resource and referral tool called the Somerville Hub Connect (powered by Findhelp). This tool allows families and community members to search for and get connected to the resources they need.
The SomerBaby Program was launched in 2020 based on community feedback. The free program welcomes new babies into the Somerville community and participants receive a home visit, home safety information, information and support on breastfeeding, and referrals to additional resources via Somerville’s Findhelp platform.
The program is actively accepting and managing applications via their listing on the Findhelp platform.

Indiana | “Pregnancy Promise Program”

The Indiana Pregnancy Promise Program (IPPP) is a free, voluntary program for pregnant Medicaid members who use opioids or have used opioids in the past. The program connects individuals to prenatal and postpartum care, treatment for opioid use disorder, and social care resources (via Findhelp). IPPP is funded by a grant from the Centers for Medicare & Medicaid Services, and is administered by Indiana’s Family and Social Services Administration (FSSA).

IPPP requires Indiana’s four Managed Care Entities (MCEs) to use their Findhelp platforms to refer pregnant members with opioid use disorder to needed social care resources.
Along with Findhelp’s dedicated Community Engagement team, these MCEs train local community organizations on how to use the Findhelp platform to accept and respond to IPPP-related referrals.

Partnership Results

Since its launch in 2022, the program has enrolled 543 Medicaid members, 94% of whom maintained recovery through 12 months postpartum.
In addition, 2,114 social care referrals for housing, transportation, nutrition, and other services have been made on behalf of participants via the participating MCEs’ Findhelp platforms.

Texas | Superior HealthPlan’s Success with Delivering Car Seats & Diapers via Findhelp’s Marketplace Fulfillment Program

Since 1999, Austin-based Superior HealthPlan (part of Centene Corporation) has been providing health care to members across Texas. Today, they support nearly 1.7 million Texas members by transforming the health of their community, one person at a time.

They launched Superior HealthPlan CARES (powered by Findhelp) in 2015.
Superior offers its members a Value-added Service called Start Smart for Your Baby®. Through this program, expectant moms can complete educational classes about self-care and baby-care during and after pregnancy. Members who complete this educational program are eligible to receive a free car seat and diapers.
From 2021 to 2023, Findhelp fulfilled orders of car seats and diapers for the Start Smart for Your Baby® program.

Partnership Results

In the project’s first year, 3,255 expectant mothers received car seats and diapers.
As a direct result of the new process, average monthly referrals increased 550% and Superiorʼs closed-loop rate jumped 500%.
The partnership created efficiencies for Superiorʼs Obstetrics Care Management team, their Supervisor, and their Director. As highlighted below, the end results exceeded expectations.

Join Us May 22: Iowa Maternal Health Solutions Roundtable Luncheon

Maternal health is a top priority for Iowa policymakers, prompting leaders to work together to identify trends, causes, and opportunities to ensure the health and well-being of families.

On May 22, from 11:30am to 1:30pm Central, Findhelp brought together Iowa leaders from across industries to discuss maternal health solutions during a luncheon at the Embassy Suites Downtown Des Moines.

Join your peers working at the forefront of health and social care integration, featuring a powerful coalition of leaders from government and healthcare organizations.

Together, we explored new policies, delved into groundbreaking innovations, and discussed impactful approaches that pave the way for transformation.

Can’t Attend the Roundtable?

You can still take advantage of Findhelp’s robust network of community programs and search for free and reduced-cost resources for Iowa parents and young children on our free website, Iowa Maternal Health.

The site features a tailored set of categories that are the most relevant for parents with young children, making it easy for you to quickly find and connect to programs that can help.

Supporting Maternal Health, Together

Connect with us to learn more about how we can partner to support maternal health.

Findhelp & the Dept. of Education Partner to Support Missouri Families and Children

We’re very proud to announce that the Missouri Department of Elementary and Secondary Education, Office of Childhood (DESE OOC) has chosen us as their technology partner to help families with children from prenatal to age five find and connect to early childhood programs and resources. Together, we’ll support Missouri families and children throughout the state.

In this week’s blog, we’ll highlight this new partnership and explore our history of supporting social care in Missouri. Stay tuned for a follow post about how we work with organizations to support early childhood intervention.

About the Missouri Office of Childhood

The DESE OOC oversees many statewide programs – including Parents as Teachers, Child Care Subsidy, and Early Intervention – that each have their own specific needs and requirements. 19.3% of children under 5 years of age in Missouri live in poverty, and the Missouri Family Resources platform (powered by Findhelp) supports more than 250,000 families in addition to state and local navigators who work on-the-ground in communities across Missouri.

Making it Easier for Families to Get Help

When it comes to self-navigating, 60% of Findhelp users search for help on their phones or other mobile devices. Findhelp community-facing platforms often have 5x as many searches and connections as customer staff sites, demonstrating the desire for individuals to find and connect to resources on their own.

Users may hesitate to share personal social needs with navigators due to shame or stigma, so it’s important to provide easy ways for them to self-navigate anonymously, at a time that’s convenient for them.

To meet families where they are, Findhelp built a mobile application for Missouri Family Resources that families and navigators can download to find and connect to programs directly from their phones. The app can be accessed for free through Apple or Google.

Analytics to Take Action

In addition to providing an intuitive database and platform for community members, the Missouri DESE OOC will also benefit from Findhelp’s robust data and analytics to better support Missouri families and children. For example, the chart below shows searches in Missouri over the past two years, broken down by social need category:

These insights will help the State identify local and statewide trends, track needs, and spot issues, enabling them to be proactive in helping more people–all while protecting user privacy. Informed by data, they can strategically allocate resources and tailor interventions.

A History of Supporting Missourians

One of the reasons the Missouri Department of Elementary and Secondary Education chose Findhelp is because we have an engaged network that’s already in place. Our network spans the entire Show-Me State and Missourians across the state are using our platform to find and connect to needed services and support.

728,615 users statewide
3,103,744 searches statewide
7,837 listed programs serving Missouri
1,290 claimed programs serving Missouri

Findhelp’s data and analytic tools can identify gaps in services and provide actionable insights to inform public policy. For example, over the past two years, monthly users and searches on findhelp’s network in Missouri jumped 551% and 11,438% respectively, reflecting our important (and rapidly growing) role in connecting Missourians to local social assistance.

Partnering for Impact in Missouri

As of April 2024, we partner with more than 15 customers through the state to connect their patients, members, students, constituents, and clients to local resources.

Here are some highlights of how these organizations successfully partner and innovate with Findhelp to lift up their communities.

Part of Centene, Home State Health Plan aims to care for patients throughout Missouri by partnering with physicians, specialists, hospitals, and other providers to ensure each member receives the right care, at the right time, in the right setting.

For almost a decade, Home State Health Plan has relied on Findhelp as their social care technology partner.

In 2015 they launched their social care platform (powered by Findhelp) to make it easy for their Medicaid members across Missouri to find help and receive services to improve health outcomes.
Since launch, more than 74,000 staff and members have made almost 160,000 searches for social care resources.
Home State Health Plan’s platform is a trusted resource for community health workers (CHWs) across the state who make sure all counties are served and there are no gaps in coverage.

Saint Luke’s Health System in Kansas City includes 14 hospitals and campuses across the Kansas City region, home care and hospice, behavioral health care, dozens of physician practices, a life care senior living community, and more.

5 years ago, in 2019, Saint Luke’s launched their Findhelp platform to support wellness for their patients and community.

Over 47,000 staff and patients have used the platform to make more than 5,000 connections to resources.
Since launch, Saint Luke’s has partnered with us to build an accountable social care network that enables intervention for non-clinical factors that impact care by connecting patients with community partners.
As part of this work, Saint Luke’s worked with Findhelp to build a Trusted Network of seven community partners. To-date, over 500 referrals have been placed to these partners, with a closed-loop rate of 87%.
Saint Luke’s integrated their Findhelp platform fully into their electronic health record (EHR) and patient portals to support more efficient workflows for all users.

Children’s Mercy is a leading independent children’s health organization dedicated to holistic care, translational research, breakthrough innovation, and educating the next generation of caregivers. They transform the health, wellbeing and potential of children, with unwavering compassion for those most vulnerable.

In the fall of 2020, Children’s Mercy’s launched their LiftUpKC platform (powered by Findhelp) for their patients and staff, to support Missouri children and families.

In a few short years, more than 36,000 staff navigators and patients have conducted over 300,000 searches on LiftUpKC.
The platform is fully integrated into two separate electronic health records (EHRs) used by Children’s Mercy, helping to connect patients more easily to resources while maintaining interoperability and supporting staff workflows.
Children’s Mercy has also created strong partnerships with local community organizations. These supportive community partnerships have allowed an additional 600 patients to be referred to organizations that can assist them with housing, utilities, food resources and more!

Support Families and Children with Findhelp

Adverse childhood experiences (ACEs), such as witnessing violence, not having enough food to eat, or experiencing homelessness or unstable housing can impact the health and wellbeing of children well into adulthood.

According to the Centers for Disease Control & Prevention (CDC), “ACEs are linked to chronic health problems, mental illness, and substance use problems in adolescence and adulthood. ACEs can also negatively impact education, job opportunities, and earning potential.”

Addressing the social needs of young children is a proven way to prevent ACEs; connect with us to learn more about how we can partner to support families.

Findhelp & Foothold: Partnering to Support New York State’s Medicaid 1115 Waiver

We’re proud to announce a new partnership with Foothold Technology, the leading provider of Human Services Electronic Health Record (EHR) and Care Coordination software, to support New York’s Medicaid 1115 waiver program.

Together, we’ll bridge the gap between mental and behavioral health care and social care, making it easier for providers in New York and beyond to support whole person care.

Integrating to Support Innovation

This new integration will support enhanced care coordination to seamlessly integrate Findhelp’s extensive referral capabilities into Foothold Care Management (FCM), offering an end-to-end solution to manage and coordinate care within a single interface, significantly reducing administrative burdens and improving care delivery.

Building on the trusted FCM platform, this integration will simplify the learning curve for staff, fostering quicker adoption and utilization of Findhelp’s resources and enhancing staff’s capability to serve their members effectively.

Through bi-directional integration, this partnership will ensure up-to-date, accurate member information and referral data within FCM, supporting a holistic approach to member care and streamlined billing processes across SCNs. Ultimately, having visibility into the referrals that are being created will give Health Homes the data they need to showcase the difference being made at both individual and aggregate levels, across their network.

Findhelp’s Comprehensive Integration Support

Our network is built for connection. We partner with care management and electronic health record (EHR) systems to integrate social care into your existing workflows, making it easy to determine eligibility, assess, refer, and track outcomes.

It’s easy to integrate Findhelp’s platform with your system of record, without sacrificing privacy or security. Our secure integrations include referral tools, outcome and care metrics, and seamless workflows across systems.

Our Comprehensive New York Network

New Yorkers trust Findhelp to connect them with the social care services they need. We partner with many of the state’s large health systems, safety net hospitals, managed care organizations (MCOs), and large cause organizations.

In the last four years, New Yorkers have completed the following actions on the Findhelp platform:

1.4 million users statewide
4.5 million searches statewide
14,000 listed programs serving New York
7,100 claimed programs serving New York

Ready to Support New York’s Medicaid 1115 Waiver

Findhelp has deep experience with successfully supporting 1115 waiver programs across the country, including in California, Massachusetts, and Indiana.

Foothold is a pioneer in the Human Services EHR and Care Coordination domain and brings unparalleled expertise and a deep commitment to New York’s healthcare ecosystem to this partnership. With a strong presence in over 60% of New York Health Homes, and serving 120,000 members monthly, Foothold’s care management platform, FCM, is ideally positioned to support SCN operations and care delivery.

FCM’s integration with Findhelp’s offerings will ensure an interoperable approach to addressing the health-related social needs of Medicaid beneficiaries.

Support for Your Social Care Network (SCN)

Leverage Findhelp’s expertise in designing successful waiver programs, honed through collaborations with state leaders nationwide. Our proven workflows simplify complex regulations, maximizing your program’s impact.

We’re here to assist you with your New York 1115 waiver program lead entity applications to ensure greater coordination of social care services for NY Medicaid members. Our products and services support every aspect of the program, from eligibility checking to claims generation and reimbursement.

Partner With Us!

Connect with one of our expert team members to explore how we can support your lead entity application for New York’s Social Care Networks (SCNs).

Medicaid Waivers by State: Findhelp and New York

More than 30 healthcare, health plan, nonprofit, and other organizations across New York have already implemented social care coordination platforms using Findhelp and are ready to hit the ground running with New York’s Medicaid 1115 waiver program, Medicaid Redesign.

Read on to discover how we can partner with you on your Medicaid Redesign lead entity application and browse some of our successful 1115 waiver program partnerships from around the country. Together, we can ensure a seamless delivery of goods and services to Medicaid members while tracking claims to report back to the State.

What Are Medicaid 1115 Waiver Programs?

Section 1115 of the Social Security Act gives states flexibility to update and improve their Medicaid programs by providing waivers authorizing experimental, pilot, or demonstration projects. Many states focus their 1115 waiver program projects on improving health outcomes by addressing Medicaid enrollees’ unmet health related social needs.

At Findhelp, we have both a history of successful Medicaid 1115 waiver program support (example: California) and deep relationships across the state of New York and beyond.

Our technology supports:

Capturing eligibility and authorization needs for 1115 waiver programs
Reporting on services rendered, codes, and data needed for invoicing and claims
Invoicing paying entities and facilitating payment to community organizations and vendors

New York’s 1115 Waiver Program: Medicaid Redesign

On January 9, 2024, CMS approved New York State’s section 1115 Waiver Amendment Request through March 27, 2024 – providing $6.7B in funding to improve the health of New Yorkers. The Medicaid Redesign program will award up to 13 social care network (SCN) lead entities.

Given our singular experience creating these programs, Findhelp is here to support your NY 1115 waiver program initiatives, from application to implementation.

Partnering to Support New Yorkers

From housing and food security to transportation, employment, education, and more, Findhelp has the tools and expertise to build your trusted network and empower informed decision-making. As lead entities begin to apply for the NYS 1115 waiver program, they’ll need to outline their plans for reliable networks of contracted community-based organizations (CBOs) to better enable HRSN screening and the delivery of social care services.

We’re here to assist you with your NYS 1115 waiver program lead entity applications to ensure greater coordination of social care services for NY Medicaid members. Our products and services support every aspect of the program, from eligibility checking to claims generation and reimbursement.

Medicaid Waivers by State

Since 2019, we’ve been partnering with our customers and trusted community partners to support Medicaid 1115 waiver programs across multiple states. We collaborate with payers, managed care organizations, accountable care organizations, and community-based organizations to configure workflows and payment processes to fit the requirements of each state’s program.

Massachusetts: Flexible Services

In response to increasing needs surrounding food, housing, and behavioral health, Massachusetts’ department of health, MassHealth, launched their 1115 demonstration waiver program, Flexible Services, in 2019.

Under Flexible Services, MassHealth pays for health-related nutrition and housing supports for certain members enrolled in an Accountable Care Organization (ACO). These ACOs pilot evidence-based approaches that address a member’s health-related social needs with the goal of improving health outcomes and reducing the total cost of health care for the member.

Starting in 2020, Findhelp partnered with Mass General and Brigham and Women’s Health to launch Flexible Services pilots with 10 community-based organizations.
Midway through 2020 we expanded our partnerships to include Boston Medical Center and SouthCoast Health and trained 7 additional community organizations to improve food and housing outcomes across the state.
Today, we are partnering with several Flexible Service ACOs to support navigation assistance for areas with higher volumes of eligible patients. In the first year of Flexible Services, 99% of patients reported that their participation improved their overall health.

California: CalAIM

On January 1, 2022, the California Department of Health Care Services launched the California Advancing and Innovating Medi-Cal (CalAIM) program, an 1115 waiver program to make Medi-Cal more equitable, coordinated, and person-centered. The program covers one-third of Californians and perinatal care for half of annual births and will impact the lives of over 14 million Californians.

CalAIM expands community-based approaches to addressing complex care for high-needs populations, such as individuals experiencing homelessness, serious mental illness, or substance use disorders, or children involved in the child welfare system. Designated navigators coordinate members’ physical and behavioral care, as well as access to critical social services.
Through 14 services such as Asthma Remediation and Housing Navigation Support, CalAIM encourages Medi-Cal managed care plans to address social determinants of health (SDoH) and offer preventative upstream interventions.
Findhelp partners with MCPs across the state like Aetna Better Health, Health Net (Centene), and Alameda Alliance for Health to support CalAIM. We enable MCP staff and ECM to order more than 445 different social services from community partners.

Looking Ahead

Findhelp has experience partnering with customers across the country to address needs like food, housing, transportation, and more, whether it’s via our fulfillment program, Marketplace, by establishing Trusted Networks of community service providers, or by collaborating with organizations like Uber Health.

We look forward to joining forces with our existing customers and community partners to advance the work of the New York State Department of Health and the goals of the upcoming NYS Medicaid 1115 waiver to connect people in need to the programs and services that can help them.

Partnering for Success

You don’t have to start from scratch with your pilot demonstrations; chat with one of our team members to learn how we can collaborate with your organization to successfully implement New York’s 1115 waiver program, using established best practices and our proven strategies.

Prospective Customers: connect with our Director of Enterprise Sales, Rachel Harris ([email protected]).
Community Organizations & Customers: reach out to our Director of Customer & Community Success, Geoff Gamm ([email protected]).
Policymakers: connect with our Regional Director for Government Relations, CG Niquette ([email protected]).

Serving Those Who’ve Served: Supporting Veterans

Every year, almost 200,000 people transition from active-duty service to life as a civilian (source). Veterans, active duty military, and their families frequently move and are unfamiliar with the resources available in their area.

This transition is complex and challenging, as veterans (and their families) have to adjust to new jobs, living situations, healthcare, finances, social networks, and more, and often don’t know where to turn for help. Findhelp is here to help you navigate serving those who’ve served.

According to the Substance Abuse and Mental Health Services Administration (SAMHSA), “transitions for veterans can be especially difficult due to shifting from the unique collective culture of military service to shaping a more individualized role in how they live, work, and interact with others”. Studies indicate that 44 to 72% experience high levels of stress during the transition period (SAMHSA).

Ensuring Veterans Get the Help They Need, When They Need it

Findhelp products and services provide many avenues for navigators to support veterans and for veterans to support themselves and their families. A few of these are highlighted below.

No Gatekeeping

There are many programs specifically intended for veterans or active duty service members, but capacity is often low. This is the benefit of the Findhelp network: we list all free and reduced-cost programs, so folks have access to a wide range of available services. Furthermore, any of our users – navigators, customer staff, people looking for help, community-based organizations, the general public – are able to suggest new programs and changes to existing programs. This inclusive participation means that our network is up-to-date, accurate, and ready, whenever needs arise.

Filtering to Find Relevant Services

For active duty service members, their knowledge of available support is typically limited to “on post” resources. Using our built-in filters, they can easily identify relevant programs geared toward supporting them, in the communities surrounding their base.

Empowered Self-Navigation

Veterans are a resilient group that have to deal with many challenges post-service, including long benefits claim processing times: the January 2024 average wait-time for the U.S. Department of Veterans Affairs to respond to an initial disability-related claim is 159.8 days.

Furthermore, State Departments of Veteran Affairs have limited staff and resources, leading to delays in receiving care. For these reasons and more, the ability for veterans and active duty service members to self-navigate on the Findhelp platform and connect themselves to resources is crucial.

To guide folks to the most relevant programs for their unique situation, Findhelp customers can configure their navigation categories and subcategories to directly address the unique needs of veterans and active duty service members.

How Findhelp Supports Veterans Nationwide Through Customer Partnerships

We partner with customers nationwide who have a goal of serving those who’ve served, whether it’s their focus population or just one of many groups they serve. Our products and services make it easy for you to connect veterans and active duty service members with on- and off-base resources that can help them. Read on to learn see the success of a few of these partnerships.

A national provider of social care solutions for Medicare Advantage and Managed Medicaid health plans, BeneLynk launched the nation’s first Veterans Services offering for Medicare Advantage plans.

In 2019, BeneLynk launched their social care platform (powered by Findhelp) for their call center navigators to connect and refer veterans and others to needed social services.
James Tongate, Vice President of Government Relations at BeneLynk, joined the organization to help his fellow veterans obtain the health benefits and employment opportunities that are available to them after leaving the service. He’s seen how issues like food insecurity and mental health issues caused by isolation were worsened by the pandemic, with many elderly veterans impacted but unaware of the programs available to them in their communities.
“Our nation and the private sector had made strides with veteran and military spouse employment opportunities through the years, but the pandemic has reversed a lot of that progress — setting veterans back to March 2013 employment numbers,” Tongate notes.

The Idaho Veterans Network (IVN) assists veterans through peer-to-peer service and support, direct financial aid, online community support, and other connections to local resources and services.

In January 2023, IVN launched the Idaho Veteran’s Guide platform (powered by Findhelp) to facilitate stronger coordination between helping professionals, veterans, and the greater Idaho community.
Navigation professionals throughout Idaho can use the Idaho Veteran’s Guide platform to connect veterans to social service programs.
IVN makes this process even easier by using Findhelp’s Featured Program functionality to highlight trusted veteran’s resources in their network, and using Favorites Folders to group recommended programs in one place for easy navigation.

The Reveille Foundation supports underserved populations with holistic case management that creates individual plans for success that brings the community of resources together to execute these plans. Housing, training, and employment are critical elements to this success.

Reveille Foundation launched the VetNet platform (powered by Findhelp) in 2022 to ensure the process of connecting veterans with community programs is easy, clear, and seamless by providing community organizations with the tools they need.
They partnered with Findhelp to design their site’s logo and branding to create a sense of camaraderie and shared experience, so that veterans feel safe and comfortable using the platform.
Reveille Foundation’s Success Coaches, who act as navigators for those in need, access VetNet through a direct link within their Salesforce system of record.

Service to the Armed Forces

American Red Cross volunteers and staff work to deliver vital services – from providing relief and support to those in crisis, to helping people be prepared to respond in emergencies.

The Hero Care Network, staffed by Red Cross volunteers, springs into action when a service member faces an emergency and needs help in a hurry.
Hero Care is just one important part of the Red Cross’ Service to the Armed Forces (SAF) function, which offers a wide range of services and programs to service members, active and retired, and their families. Nationwide, the Hero Care Network handles about 150,000 cases a year.
The Red Cross’ SAF and Military & Veteran Caregiver Network departments serve veterans, active duty military, and their families via the Hero Care Network platform (powered by Findhelp), which also supports anonymous community self-navigation and workflows for case managers.
Since launching in 2018, users have made over 162,025 searches and 16,635 connections on the American Red Cross Findhelp network.

Getting Help: a Real Veteran Success Story

Below is a real example of a customer success story, where a veteran self-navigated on the Idaho Veterans Network’s Findhelp platform and quickly received the help they were looking for. This is just one example of how our platform can be used to help support veterans; our customers have flexibility to configure their workflows to best fit the capacity of their organizations and the needs of the populations they serve.

Support Veterans with Findhelp

Schedule a demo with us to see how we can partner with your organization to help veterans and active duty service members adjust to civilian life and support their families.

Partnering with HIEs to Support Pennsylvanians in Need

We are thrilled to announce that we have been awarded a contract with the Consortium of Health Information Exchanges (HIEs), funded by the Commonwealth of Pennsylvania’s Department of Human Services, to build a statewide online tool called PA Navigate that will connect Pennsylvanians in need of social care services with providers.

Findhelp has partnered with the HIE Consortium members (Central PA Connect, ClinicalConnect HIE, HealthShare Exchange, and Keystone Health Information Exchange) to build and support a system that addresses the social drivers of health (SDoH). Consortium members will use PA Navigate, powered by Findhelp’s closed-loop referral system and nationwide social care network, to assess the SDoH needs of Pennsylvanians and refer them to providers, with dignity and ease.

Successful HIE Support: Idaho Health Data Exchange (IHDE)

Health information exchanges (HIEs) exist to “support health care professionals and patients to appropriately access and securely share a patient’s medical information electronically” (HealthIT.gov). At Findhelp, we have established best practices for supporting HIEs, from Idaho to Washington, D.C. and in-between. Below is just one example of how we partner to bridge the gap between medical and social drivers of health (SDoH) data.

About IHDE

IHDE is a non-profit 501(c)(3) company and Idaho’s statewide HIE; they are dedicated to meeting the needs of healthcare providers and ensuring that Idaho’s citizens receive the most effective health services possible. IHDE works with a wide array of stakeholders to actively deliver best in breed technology infrastructure. They provide access to reliable data and information, combining traditional healthcare data with other data sources to help address the medical, behavioral, and social needs that influence the well-being of Idahoans.

Partnering with Findhelp

IHDE has partnered with Findhelp since 2020 to better support clinical operations across the state through access to validated social care assessments, which both help providers who serve Idaho Medicaid beneficiaries and better enable them to refer patients to appropriate services in their community.

In this partnership, Findhelp facilitates service provider outreach and engagement on behalf of a collective of organizations, including local United Ways, hospital systems, health centers, YMCAs, regional governmental agencies, food banks, and many others. Through these collaborative endeavors, Findhelp supports IHDE and its membership in deepening partnerships, better understanding needs, and developing novel strategies to more effectively and efficiently deliver services.

Our Network in Pennsylvania

One of the reasons the Consortium chose Findhelp is because we have an engaged network that’s already in place. Our network spans the entire Keystone State and Pennsylvanians across the Commonwealth are using our platform to find and connect to needed services and support. Additionally, our superior integration capabilities, financial incentives to community-based organizations, and #1 rating by KLAS, a healthcare research firm, further recommended us.

1,406,976 users statewide
4,758,681 searches statewide
12,362 listed programs serving Pennsylvania
2,525 claimed programs serving Pennsylvania

Findhelp’s data and analytic tools can identify gaps in services and provide actionable insights to inform public policy. For example, over the past two years, monthly users and searches on Findhelp’s network in Pennsylvania jumped 129% and 96% respectively, reflecting our important (and growing) role in connecting Pennsylvanians to local social assistance.

Partnering for Success in Pennsylvania

Over the past five years more than 750,000 Pennsylvanians have already used Findhelp to connect with social care services. As of January 2024, we partner with ~40 customers through the Commonwealth to connect their patients, members, students, constituents, and clients to local resources.

Here are some highlights of how these organizations successfully partner and innovate with us to lift up their communities.

Highmark Health

A national blended health organization, Highmark Health and their businesses support millions of customers with products, services, and solutions aligned to their mission of creating remarkable health experiences, freeing people to be their best. Headquartered in Pittsburgh, they are regionally-focused in Pennsylvania, Delaware, West Virginia, and eastern and northwestern New York with customers in 50 states and the District of Columbia.

In partnership with Findhelp, Highmark launched their Findhelp platform in August 2020 and have created a Trusted Network of more than 100 social service programs in Pennsylvania to receive referrals from their staff, patients, and members.

Washington County

Washington County Department of Human Services supports individual and family needs of Washington County residents in order to promote self-sufficiency and improve their quality of life.

They launched the Help In Washington platform (powered by Findhelp) in June 2022; since then, more than 2,500 community members have sought assistance with food, housing, employment, and more. The County has raised awareness for this service through the use of creative postcards and QR codes which they distribute at their events.

The county’s help center, housing coordinators, veterans assistants, and youth services coordinators all leverage Help In Washington to streamline their workflows while making it easier for Washington County residents to get the support they need. County staff are also working closely with public school guidance counselors to provide additional support and training to enable them to leverage the platform to address their students’ social needs.

Geisinger Health

Geisinger Health is a health and wellness organization focused on making better health easier for Pennsylvania communities through primary care, specialty medicine, pharmacies, health plan options, and more. Operating for more than 100 years with over 24,000 employees, innovation through transformative healthcare delivery is at the core of their model.

In 2020, Geisinger launched their Neighborly platform (powered by Findhelp) to assist patients and members in navigating for social care services. Since then, they have expanded into staff referrals via an integration with their Epic electronic health record (EHR) system and continue to innovate by establishing relationships with local nonprofits to improve patient experiences, quality, efficiency, and outcomes.

Next Steps for PA Navigate & Pennsylvania

On January 23, 2024, Pennsylvania Department of Human Services (DHS) Secretary Dr. Val Arkoosh, Findhelp Founder & CEO Erine Gray, and Community Action Partnership (CAP) Lancaster CEO Vanessa Philbert introduced PA Navigate’s public-facing website, pa-navigate.org, the first step in a multi-year project.

Not only will individuals be able to find help for themselves via the platform, but local nonprofits, healthcare organizations, state and county agencies, and community-based organizations will be able to refer individuals for assistance related to their social care needs. These agencies will also be able to track the outcomes of these referrals to ensure individuals’ needs have been met.

Lancaster, PA. (L-R) Erine Gray, Alice Yoder, Keith Cromwell, Dr. Val Arkoosh and Vanessa Philbert, pose for a group photo after Tuesday’s PA Navigate launch event on January 23, 2024.

We Can Help

To learn how we can help you support your constituents, connect with our team.