The Shift to Social Care Contracting Between Health Care Entities and Community-Based Organizations

Area Agencies on Aging (AAAs) play a critical role in coordinating health-related social services such as nutrition and medical transportation for older adults in their communities, yet their formal engagement with health care entities varies widely. This study examines organizational characteristics of AAAs associated with their shift to contracting with health care organizations. The study analyzed data using repeated waves of the National Survey of AAAs and the Community-Based Organization-Health Care Contracting Survey. Logistic regression assessed how organizational characteristics are associated with contract formation. Findings reveal that shifting into formal contracting was more likely for independent non-profit AAAs, those AAAs that provided care transition services, and AAAs with high annual budgets. Higher proportion of funding received from the Older Americans Act was negatively associated with a change in contracting status. This study suggests that organizational autonomy, financial stability, and diverse funding streams are associated with a higher capacity for entering into health care contracts.