A Turning Point in Medicare Policy: Guiding Principles for New Flexibility Under Special Supplemental Benefits for the Chronically Ill How to implement the new Medicare benefits. Implementation Tool July 2019
Home-Based Primary Care Resources: A Toolkit for Health Partners This toolkit details the benefits of home-based primary care to help providers demonstrate the need for these programs. Implementation Tool June 2019
Addressing Health Equity through Health and Housing Partnerships Strategies for health centers and supportive housing providers to advance health equity by partnering to provide person-centered care. Implementation Tool May 2019
Home-Based Primary Care Fall Prevention and Management Toolkit Shares best practices and screening tool options to identify and care for home-based primary care patients with potential fall risks. Implementation Tool April 2019
Identifying and Designing the Right Care Management Program: Insights from ACOs Four care management models for ACOs. Implementation Tool April 2019
State Pathways to Integrated Care: Exploring Options for Medicare-Medicaid Integration Outlines steps states can take to advance Medicare-Medicaid integration depending on policy goals, internal capacity, and delivery system structures. Implementation Tool April 2019
Identification and Assessment Toolkit for Patients with Serious Illness Includes case studies, clinical assessment tools, and other resources for identifying and assessing the needs of patients with serious illness. Implementation Tool March 2019
Health Care Transformation Task Force Value Partnership Evaluation Tool A tool for assessing readiness for value-based partnerships. Implementation Tool March 2019
Strengthening Medicaid Long-Term Services and Supports: A Toolkit for States This resource explains how states can improve their Medicaid LTSS systems. Implementation Tool March 2019
The Guide to Integrating Palliative Care into Population Management Practical strategies for health plans and ACOs to improve care for patients with serious illness. Implementation Tool February 2019
High-Need, High-Cost Personas An in-depth overview of different personas. Implementation Tool February 2019
The Opioid Use Disorder Prevention Playbook Strategies for preventing opioid use disorder. Implementation Tool February 2019
Re-envisioning Care for People with Involved Disabilities Video series details how health systems can redesign primary care, including through home-based primary care programs, to better meet the needs of people with disabilities. Implementation Tool February 2019
Designing and Implementing Home-Based Palliative Care: A Guide for Payers A practical guide for payers to create a home-based palliative care program centered upon a value-based case example from a payer’s perspective. Implementation Tool January 2019
Blueprint for Complex Care: Advancing the Field of Care for Individuals with Complex Health and Social Needs This resource outlines the current state of complex care and recommendations for the future. Implementation Tool December 2018
The ROI Calculator for Partnerships to Address the Social Determinants of Health A web-based financial tool that helps navigate partnerships between health care organizations and social service organizations. Implementation Tool August 2018
Care Management Contracting for Complex Populations: Best Practices and Tools This resource offers guidance on contracting for populations with complex needs. Implementation Tool July 2018
Investing in Social Services as a Core Strategy for Healthcare Organizations: Developing the Business Case This resource explains how to invest in social services as a business strategy. Implementation Tool March 2018
Care Ecosystem Toolkit Details implementation guidance for the evidence-based Care Ecosystem model, which improves supports for people with dementia and their caregivers. Implementation Tool February 2018