Growing evidence suggests the importance of economic stability, physical environment, education, food, and social context in determining one’s health before the health system is able to intervene (Nichols & Taylor, 2018; Taylor et al., 2016). Non-medical spending on these social determinants of health (SDOH), including social work interventions, may have an impact on health outcomes.
The Waco Connect (WC) project, part of a national series of Collaborative Approach to Public Good Investment (CAPGI) projects, is a social care navigation program coordinated between April 2021 and February 2023 by Prosper Waco in Waco, Texas. WC aims to connect families experiencing mental health needs in McLennan County, Texas, to a network of non-medical resources. In partnership with Baylor Scott & White Health (BSWH), the families of Medicaid-enrolled children (under 19) who have serious anxiety and depression were selected and provided the opportunity to be linked to social care providers through referrals.
Our team was contracted to serve as the local evaluator for WC. The purpose of this evaluation is to assess whether the WC project – as an intervention to invest in SDOH – reduced the utilization and costs of medical services for high-risk patients with social needs. The implementation process of WC, as described in this report, is based on internal reports from and conversations with key personnel at Prosper Waco. Using fully de-identified data on referrals provided by Prosper Waco and on utilization from BSWH, we use matching on observables methods to estimate the impact of the WC intervention. We interpret these results in the context of prior literature on SDOH social care interventions, including referral interventions.
Overall, 311 referrals were made by BSWH to Prosper Waco between April 2021 and February 2023, of which 291 clients resulted in successful contact and 232 clients had their social needs identified. A majority of WC clients were in need of assistance with housing (143 clients) and utilities (131 clients), and other notable social needs included food (79 clients) and childcare (60 clients), followed by employment, social/emotional support, healthcare, and transportation. Of these clients, 100 of them reported having at least one of their social needs met during the study period. We conducted an evaluation of the WC intervention on the health outcomes of 258 WC clients that had complete healthcare data, compared to 12,504 matched controls in the BSWH Medicaid plan, and found no evidence of reduced cost of care but some evidence of reductions in the number of emergency department (ED) visits following WC referrals.
