Table 1.

Overview of Embedded and Standalone Programs (N = 27)

Embedded Programs (n = 15)		Standalone Programs (n = 12)
Key Features	Example Quote	Key Features	Example Quote
Activities to address social needs were embedded within existing clinical care management programs. Motivated to address needs that impacted clinical care Provided referrals to CBOs Provided information, coached patients, assisted with paperwork, attended appointments Relied on existing care management staff Patients were enrolled in care management due to clinical conditions or recent hospitalization Social needs often identified after enrollment	“When we’re monitoring them, they’ve either been uncontrolled or been in the hospital in the last six months, so they’ll either be monthly or biweekly calls. And when they’re just, multiple chronics, multiple hospitalizations, then we want to go to bimonthly or weekly calls.” (Practice; O14; case management staff)	Focused on addressing social needs independent of clinical activities. Motivated to address social needs because of their mission Addressed social needs regardless of clinical need or complexity Provided information, coached patients, assisted with paper-work, attended appointments Primarily staffed by community health workers and social workers Social needs identified via screening or provider referral	“It typically looks like a personal introduction by the clinic that’s serving the member or patient, so that they’re saying, ‘As your care team, we want to bring in [community health worker] as a part of the care team to be a part of our work with you, and we’d really like to have her come out to your home and meet you or whatever you would prefer. Would you be willing to engage in that?’ They’re really trying to do a warm intro and hand-off, and then that person is following up through whatever mechanism the patient said they preferred, a phone call, a text, a visit.” (System; O5; executive leadership)

CBOs = community-based organizations; O = organization.