The U.S. had the highest rate of cost-related access problems.

There are many promising strategies to segment individuals with complex needs. Here is one conceptual framework.

Health Resilience Specialists work with the patients to meet their personal health needs

This resource provides a definition and essential elements of person-centered care.

Targeting is important, even within the high-need patients enrolled in the program.

Much of the evidence comes from small studies, so further testing is needed.

Key opportunities include strengthening information technology connections across service providers.

Segmenting the high-cost population is the first step in matching appropriate care management strategies.

This report presents the findings from the evaluation of Medicaid health homes, created as part of the Affordable Care Act.

The Department of Veterans Affairs home-based primary care program reduced total costs of care for VA and Medicare and earned high satisfaction ratings from patients and their caregivers.

Setting up data collection systems is important to showing value.

Indicates that a community-based nurse care management model reduced all-cause mortality for older adults with chronic conditions.

Lessons learned from eight health care organizations can help you design a successful program.