A Clinical Pathway to Well-Being: Putting Patient Priorities at the Center of Care A care management model designed to center patients’ health priorities shows promising results. Peer-Reviewed Article October 2023
Care Ecosystem Collaborative Model and Health Care Costs in Medicare Beneficiaries with Dementia Randomized controlled trial shows that a collaborative dementia care model leads to reduction in costs among a sample of Medicare patients. Peer-Reviewed Article September 2023
Addressing Healthcare Utilization and Costs for Older Adults with Limited Mobility Through a Multidisciplinary Home-Based Primary Care Program An interdisciplinary home-based primary care program for older adults with limited mobility leads to reductions in health care utilization and costs. Peer-Reviewed Article August 2023
The Association Between Primary Care Practices’ Structural Capabilities and Hospitalizations Among Persons Living with Dementia Care coordination services in primary care clinics are shown to reduce avoidable hospitalizations among persons living with dementia. Peer-Reviewed Article July 2023
Dosage and Outcomes in a Complex Care Intervention Implementation of a high-dose care management intervention for patients with complex health and social needs can reduce hospitalization rates. Peer-Reviewed Article June 2023
Dementia Care Navigation: Building Toward a Common Definition, Key Principles, and Outcomes An expert panel proposed key principles for designing care navigation programs for persons living with dementia and their caregivers. Peer-Reviewed Article April 2023
Complex Community Health and Social Care Interventions – Which Features Lead to Reductions in Hospitalizations for Ambulatory Care Sensitive Conditions? A Systematic Literature Review Primary care-based interventions that integrate community health and social care services can reduce the rate of avoidable hospitalizations. Peer-Reviewed Article December 2022
Effect of a Community Health Worker Intervention on Acute Care Use, Advance Care Planning, and Patient-Reported Outcomes Among Adults With Advanced Stages of Cancer Community health worker-led advance care planning and symptom screening program reduced acute care use for patients with advanced stages of cancer. Peer-Reviewed Article June 2022
Impacts of Community-Based Care Program on Health Care Utilization and Cost Community-based care management programs for patients with complex health and social needs have the potential to reduce hospitalizations and inpatient costs. Peer-Reviewed Article April 2022
Health Care Hotspotting — A Randomized, Controlled Trial Randomized controlled trial of a care management intervention offers important lessons for the field of complex care. Peer-Reviewed Article January 2020
Going Beyond Clinical Care to Reduce Health Care Spending A regional approach to health care transformation. Peer-Reviewed Article July 2018
Bending the Spending Curve: The Role of Care Management in a Pioneer ACO ACOs have lowered costs for high-need patients through care management programs focused on modifiable spending. Peer-Reviewed Article May 2017
Innovative Home Visit Models Associated with Reductions in Costs, Hospitalizations, and Emergency Department Use Home visits can reach patients with complex needs before a higher level of care is needed Peer-Reviewed Article March 2017