Use of hospital readmission rates to measure quality may be unfair for some accountable care organizations and safety-net providers, since members with complex medical and social needs are a main driver of these rates.
An intervention supporting caregivers of adults with chronic medical and functional needs can generate cost savings and improve outcomes for Medicare Advantage enrollees and their caregivers.
Primary care and alternative payment models that reduce emergency department use and increase access to care for high-need populations share core components for success.
Guidance on partnering with community-based organizations to provide services such as meal delivery and transportation for dually eligible individuals.
Home-based intensive care model for Medicaid and dually eligible enrollees with complex needs led to positive health outcomes and reduced acute care spending, particularly for individuals with a behavioral health diagnosis.
Use of machine learning clustering algorithms revealed 30 distinct subgroups of patients among high-risk veterans, indicating a need for tailored approaches to health care.
Analysis of recent and projected growth of expanded supplemental benefits offered by Medicare Advantage plans — such as meals, transportation, and in-home support services.
Discusses the benefits and challenges of tele-social care and offers practical tips for providers administering telehealth services for social care activities.
Suggests that community-based organizations are responding to Medicaid redesign efforts that prioritize social determinants of health by adopting practices similar to health care organizations.
Examines the early implementation of Medicare Advantage expanded supplemental benefits, along with policy considerations to promote plan adoption and beneficiary access to these benefits.
Provides practical steps for current or potential future Medicare accountable care organizations to transform the delivery of care, including through telehealth, home visits, and skilled nursing care.