Explores the epidemiology and characteristics of homebound older adults, inequities they face, and reimagines care delivery for this population.

Features Karla Silverman, MS, RN, CNM, Associate Director for Complex Care Delivery at the Center for Health Care Strategies, who highlights the need to expand what measures are used to assess the quality of care delivery.

Details the elements of Rush@Home’s care model and shares the impact and insights from implementing this home-based primary care program.

Describes the Department of Veterans Affairs' successful approach to home-based primary care.

Predicts what the field of complex care may look like under the Biden-Harris administration and identifies opportunities to strengthen the field.

Health Quality Partners shares lessons for other organizations that may be interested in implementing complex care programs.

CommonSpirit Health share their insights about the process of implementing social needs screening and integrating community health workers into care.

Leadership from the California Community Foundation and Southside Coalition of Community Health Centers explore their health information exchange pilot.

Highlights PACE programs’ efforts to redesign care during the COVID-19 pandemic and presents policy options that may help to expand access to the programs in the future.

Features a conversation with Heidi Bossley and Keziah Imbeah, authors of the recently published Measuring Complexity report, who share insights into the findings and considerations for the field in adopting a more standardized approach to complex care measurement.

A community health worker and social worker from CareMore Health share their perspective on the importance of their roles in lowering costs and improving outcomes for high-need patients.

Describes key opportunities for the continued development of complex care best practices, gleaned from recent randomized controlled trials.

Features a conversation with Miriam Komaromy, MD, former ECHO Care lead, who shared key takeaways from the recent evaluation of the intervention to help inform complex care programs.

Features David Labby, MD, health strategy advisor for Health Share of Oregon, who provides insights on the recently released report on Camden Coalition's randomized controlled trial on the Camden Core Model.

Christine Schaeffer, MD, medical director of Northwestern Medicine Transitional Care Clinic, describes the core components of its transitional care program. She also shares important considerations for health systems interested in implementing person-centered transitional care.

Primary care initiatives have shown that enhancing primary care can coordinate service delivery to the benefit of both patients and clinicians. In Medicare ACOs, primary care transformation has been foundational for shifting to a team-based approach that reaps benefits for everyone involved.

Caroline Morgan Berchuck, MD, describes a promising new complex care hospitalist model that aims to address this fragmentation and support people with complex needs in realizing better health outcomes.

Dr. Mark Prather, emergency physician and founder of Dispatch Health, shares how his organization provides on-demand home visits in 10 metropolitan areas and provided nearly visits to nearly 100,000 visits to patients last year.

Dr. Neglia and The Holston Medical Group have established a unique program that cares for acutely ill patients in an ambulatory setting even though their illnesses would qualify for an inpatient hospitalization.

A new care delivery model of providing hospital-level services in the home (sometimes referred to as “home hospitalization” or “hospital at home”) has been launching with pilots at a number of health systems nationally.