Implementing Innovative Value-based Financing Models to Promote the Sustainability of Medical Legal Partnerships in Kentucky

Implementing innovative value-based financing models to promote the sustainability of Medical Legal Partnerships in Kentucky Abstract The evidence is growing on the need to intervene on health harming SDOH at the point of care by integrating multilevel medical, social, financial and legal health solutions to positively impact health inequities. One example of this is a Medical-Legal Partnership (MLP)- an innovative, integrated, and collaborative model that embeds legal services in the healthcare setting to address health-harming SDOH among underserved populations. However, despite establishing financial benefit for patients and health systems, the sustainability of MLPs are threatened due to limitations in funding. The overall goal of my proposed project is to establish effective strategies to implement innovative value-based financing models that promote sustainability of MLPs within health systems. A mixed method, non-randomized design guided by the Consolidated Framework for Implementation Research will be used for this study. To examine best practices and successful models of implementing innovative value-based financing models for sustaining MLPs (Aim 1), I will conduct in-person site visits at 5 organizations leading the field in implementing value-based payment arrangements, Delivery System Reform Incentive Payment Programs, or other innovative financing models to sustain their MLPs. Key-informant interviews will be conducted with roughly 10 participants at each site. In Aim 2, I will interview roughly 30 policy makers, stakeholders, and community partners in Kentucky to identify elements or data that they recommend need to be present in designing and sustaining a state-funded, innovative financing model for MLPs. These interviews will start with a strategic presentation of Aim 1 findings to help provide background, context, and initiate conversations around what data they would need to see to support and/or advocate for a state funded MLP. Findings from Aims 1 and 2 will be applied to evaluate an existing and new MLP in pediatric and adult oncology settings (respectively) to support value- based data (Aim 3). Data will be collected on acceptability of MLP services, health outcomes, financial benefits to patients and families, and institutional return on investment. After completion of the study, strategic methods will be used to disseminate findings back to legislators and policy makers in Aim 2 to build partnerships and lead policy-level changes in value-based payment reforms to support the sustainability of MLPs in Kentucky.