{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T14:57:14Z","timestamp":1790521034670,"version":"4.1.0"},"reference-count":24,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T00:00:00Z","timestamp":1790121600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100000909","name":"John A. Hartford Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000909","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Appl Gerontol"],"abstract":"<jats:p>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.<\/jats:p>","DOI":"10.1177\/07334648261490400","type":"journal-article","created":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T15:00:56Z","timestamp":1790175656000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["The Shift to Social Care Contracting Between Health Care Entities and Community-Based Organizations"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2840-4181","authenticated-orcid":false,"given":"Isha","family":"Karmacharya","sequence":"first","affiliation":[{"name":"Miami University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7779-6233","authenticated-orcid":false,"given":"Krishna Prasad","family":"Sapkota","sequence":"additional","affiliation":[{"name":"Miami University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4577-6828","authenticated-orcid":false,"given":"Robert J.","family":"Graham","sequence":"additional","affiliation":[{"name":"Center for Academic Faithfulness & Flourishing"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Blair","sequence":"additional","affiliation":[{"name":"USAging"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7010-728X","authenticated-orcid":false,"given":"Traci","family":"Wilson","sequence":"additional","affiliation":[{"name":"USAging"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suzanne R.","family":"Kunkel","sequence":"additional","affiliation":[{"name":"Miami University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,9,23]]},"reference":[{"key":"e_1_3_8_2_1","doi-asserted-by":"publisher","DOI":"10.1108\/JOE-05-2020-0021"},{"key":"e_1_3_8_3_1","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2019.01515"},{"key":"e_1_3_8_4_1","doi-asserted-by":"publisher","DOI":"10.1177\/07334648221096137"},{"key":"e_1_3_8_5_1","doi-asserted-by":"publisher","DOI":"10.26419\/ppi.00151.001"},{"key":"e_1_3_8_6_1","volume-title":"Older Americans act: Overview and funding [legislation]","author":"Colello K. 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Older Americans act: Grants to state and community programs on aging; grants to Indian tribes and native Hawaiian grantees for supportive, nutrition, and caregiver services; grants for supportive and nutritional services to older Hawaiian natives; and allotments for vulnerable elder rights protection activities. Administration for Community Living (ACL), Department of Health and Human Services. https:\/\/www.federalregister.gov\/documents\/2024\/02\/14\/2024-01913\/older-americans-act-grants-to-state-and-community-programs-on-aging-grants-to-indian-tribes-and"},{"key":"e_1_3_8_8_1","volume-title":"Social determinants of health\u2014healthy people 2030 | health.gov","author":"Department of Health & Human Services","unstructured":"Department of Health & Human Services. (n d). Social determinants of health\u2014healthy people 2030 | health.gov. Retrieved August 11, 2024, from. https:\/\/health.gov\/healthypeople\/priority-areas\/social-determinants-health"},{"key":"e_1_3_8_9_1","volume-title":"HHS call to action: Addressing health-related social needs in communities across the nation","author":"Department of Health & Human Services","year":"2023","unstructured":"Department of Health & Human Services. (2023). HHS call to action: Addressing health-related social needs in communities across the nation. Department of Health & Human Services. https:\/\/aspe.hhs.gov\/sites\/default\/files\/documents\/3e2f6140d0087435cc6832bf8cf32618\/hhs-call-to-action-health-related-social-needs.pdf#:\u223c:text=NeedsinCommunitiesAcrosstheNationHHS,thehealthandwell%2DbeingofeveryAmerican"},{"key":"e_1_3_8_10_1","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2019.01594"},{"key":"e_1_3_8_11_1","doi-asserted-by":"publisher","DOI":"10.1093\/geront\/gnac124"},{"key":"e_1_3_8_12_1","volume-title":"Developing national social care standards","author":"Gottlieb L. M.","year":"2023","unstructured":"Gottlieb L. M., DeSilvey S. C., Fichtenberg C., Bernheim S., Peltz A. (2023). Developing national social care standards. Health Affairs. https:\/\/doi.org\/10.1377\/forefront.20230221.857308"},{"key":"e_1_3_8_13_1","volume-title":"The national survey of area agencies on aging: 2022 results","author":"Graham R. J.","year":"2024","unstructured":"Graham R. J., Kunkel S. R., Karmacharya I. (2024). The national survey of area agencies on aging: 2022 results. Scripps Gerontology Center, Miami University. https:\/\/miamioh.edu\/cas\/centers-institutes\/scripps-gerontology-center\/research\/publications\/2024\/the-national-survey-of-area-agencies-on-aging-2022-results.html"},{"key":"e_1_3_8_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pop.2019.07.013"},{"key":"e_1_3_8_15_1","article-title":"Advancing partnerships: Contracting between community-based organizations and health care entities","author":"Kunkel S. R.","year":"2022","unstructured":"Kunkel S. R., Lackmeyer A. E., Graham R. J., Straker J. K. (2022). Advancing partnerships: Contracting between community-based organizations and health care entities. Scripps Gerontology Center. https:\/\/scdb.lib.miamioh.edu\/server\/api\/core\/bitstreams\/ce2ef9ab-f337-4030-8a18-5c6e1f6dac84\/content.","journal-title":"Scripps Gerontology Center"},{"key":"e_1_3_8_16_1","volume-title":"mbracing the shift: The impact of health care contracting on community-based organizations","author":"Kunkel S. R.","year":"2024","unstructured":"Kunkel S. R., Lackmeyer A. E., Karmacharya I. (2024). Embracing the shift: The impact of health care contracting on community-based organizations. Available from. https:\/\/www.aginganddisabilitybusinessinstitute.org\/wp-content\/uploads\/2025\/01\/Embracing-The-Shift-December-2024.pdf"},{"key":"e_1_3_8_17_1","volume-title":"Community-based organizations and health care contracting: Building & strengthening partnerships","author":"Kunkel S. R.","year":"2018","unstructured":"Kunkel S. R., Lackmeyer A. E., Straker J. K., Wilson T. L. (2018). Community-based organizations and health care contracting: Building & strengthening partnerships. Scripps Gerontology Center. Miami University. https:\/\/miamioh.edu\/cas\/centers-institutes\/scripps-gerontology-center\/research\/publications\/2018\/community-based-organizations-and-health-care-contracting-building-and-strengthening-partnerships.html"},{"key":"e_1_3_8_18_1","volume-title":"Integrating social care into the delivery of health care: Moving upstream to improve the nation\u2019s health","author":"National Academies of Sciences, Engineering, and Medicine","year":"2019","unstructured":"National Academies of Sciences, Engineering, and Medicine. (2019). Integrating social care into the delivery of health care: Moving upstream to improve the nation\u2019s health. The National Academies Press. https:\/\/doi.org\/10.17226\/25467"},{"key":"e_1_3_8_19_1","volume-title":"What are community care hubs?","author":"Pferr L.","year":"2023","unstructured":"Pferr L. (2023). What are community care hubs? https:\/\/www.ncoa.org\/article\/community-care-hubs-what-evidence-based-program-providers-need-to-know\/"},{"key":"e_1_3_8_20_1","volume-title":"Final evaluation report: Evaluation of the community-based care transitions program","author":"Ruiz D.","year":"2017","unstructured":"Ruiz D., McNealy K., Corey K., Simmerman J., Zurovac J., McLaughlin C., Barna M., Mleczko M. (2017). Final evaluation report: Evaluation of the community-based care transitions program. Centers for Medicare and Medicaid Services. https:\/\/downloads.cms.gov\/files\/cmmi\/cctp-final-eval-rpt.pdf"},{"key":"e_1_3_8_21_1","volume-title":"StataCorp, 2025, College Station, TX","author":"StataCorp LLC","year":"2025","unstructured":"StataCorp LLC. (2025). StataCorp, 2025, College Station, TX. 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