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Abstract

Poverty and financial insecurity are major drivers of poor health outcomes, but health systems have traditionally lacked the tools to address these economic drivers of health. In recent years, an innovative clinical care model is starting to change that: Medical-Financial Partnerships (MFPs). Medical-Financial Partnerships are collaborations between health care systems and financial services providers. They connect patients to a variety of financial services including financial coaching, free tax preparation, and public benefits navigation. These services have been shown to significantly improve health and financial well-being. In addition, MFPs provide effective and welcome access points for under-utilized social service and anti-poverty public benefits programs. Most MFPs are grant-funded, but given their benefits to patient health and social service access, they may be able to grow by attracting investments from social service providers, healthcare systems, and payors as well. Finally, MFPs transcend the limitations of the traditional medical model and can even transform it in important ways. First, they use strengths-based approaches like financial coaching and motivational interviewing in a medical model that relies heavily on problem-based diagnoses to organize, prioritize, and incentivize care. Second, they bring community-level resources and interventions to a medical system that operates primarily at the individual-level. Third, they bring upstream health interventions like financial supports and policy advocacy to a medical model that focuses on more downstream causes of illness. Overall, MFPs represent an important and effective set of tools and a novel approach to health promotion within a broader health care strategy to address the economic and structural drivers of health.

Key Take Away Points

  • Medical-Financial Partnerships (MFPs) are collaborations between healthcare institutions and financial service organizations that provide patients and their families financial coaching, free tax filing, and other services to address the economic drivers of health.
  • There is substantial evidence that the services MFPs provide improve the recipients’ health and financial well-being, and there is a growing body of evidence suggesting that MFPs are particularly desirable and effective sites for receiving these services.
  • Strengths-based, community-level, and upstream-oriented aspects of the MFP model help clinics to move beyond the limits of the traditional medical model to provide more holistic care that addresses the “causes of the causes” of poor health.

Author Biography

Geoffrey Gusoff MD, MBA, MS is a family medicine physician and post-doctoral fellow with the National Clinician Scholars Program and the Department of Family Medicine at UCLA. He sees patients at the Lomita Family Medicine Clinic of the Los Angeles Department of Health Services, where he has assisted in the implementation of the Harbor-UCLA MFP. Adam Schickedanz MD, PhD is a pediatrician and clinician-researcher in the Department of Pediatrics at UCLA. He is the founder and co-director of the Harbor-UCLA Medical Financial Partnership.

Acknowledgements

The authors would like to thank the Medical-Financial Partnership staff, partners, and participants whose insights, experience, and pioneering efforts have informed our understanding of the role and potential of MFPs. Dr. Gusoff reports support from the UCLA CTSI (TL1TR001883) and the UCLA Department of Family Medicine via the National Clinician Scholars Program at the University of California, Los Angeles. Dr. Schickedanz was funded by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (HD K23099308) and the Health Resources and Services Administration Life Course Intervention Research Network (UA6MC32492).

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