Cross-Sector Partnerships and Emergency Department Use Among Older Adults: Evidence From Colorado’s Accountable Health Communities Model

Health-related social needs (HRSNs) have been associated with increased emergency department (ED) use among older adults. The Accountable Health Communities (AHC) Model, through its Assistance and Alignment Tracks, was implemented to reduce healthcare use by connecting Medicare beneficiaries to community resources that addressed their HRSNs. This study employed a two-way fixed effects difference-in-differences (DiD) analysis using county-level claims data from the Colorado All-Payer Claims Database (2014-2019) to assess the impact of the AHC Model's Alignment Track on ED visits among Medicare beneficiaries. Results show a reduction of nearly 26 all-cause and nine preventable ED visits per 1,000 people in counties served by one of the two implementing organizations. However, pre-existing declining trends raise concerns about the effects being directly attributed to the program. Further research is needed to determine whether, and through what mechanisms, the AHC Alignment Track influences ED use among older adults in Colorado.