Providers can apply these tools when designing and refining telehealth services delivery to meet the needs of older adults with a range of physical, cognitive, linguistic, and cultural differences.

This conversation guide can help providers facilitate emotionally safe and comprehensive conversations with patients who have serious illness.

Toolkit provides best practices and practical tools for designing, implementing, and evaluating the impact of community health workers.

A provider tool that promotes person-centered and equitable care by recognizing and avoiding bias in electronic health record notes.

This toolkit supports organizations to bill for community health workers/promotores interventions.

Toolkit to help palliative care professionals better understand current disparities in palliative care outcomes and design more equitable, patient-centered care approaches.

This tool can be used to guide state policy planning for a community-based palliative care benefit in Medicaid.

This guide describes key strategies for health plans, accountable care organizations, and health systems to improve care for people with serious illness.

Describes the core elements and evidence base behind a home- and community-based palliative care model that was designed by stakeholders to support the health needs of people with serious illness.

These resources can help nurses educate and support family caregivers in performing complex medical tasks for their family members at home.

Segmentation framework with publicly available code files identifies specific and actionable patient cohorts with complex needs.

This toolkit can support health care organizations in creating the business case for complex care programs.

Downloadable tools, tip sheets, sample forms, and how-to guides on home-based primary care, with a focus on clinical and operational best practices.

Contains practical guides, tools, and other resources for developing complex care programs.

Presents a framework and tools to help health care organizations and communities design a community-based palliative care program to meet patient needs in rural settings.

Health care organizations can use population-level data sources about the experiences of people with disabilities to improve care.

Includes promising practices, recommendations, vignettes, and other helpful tools to assist health systems in supporting family caregivers providing complex care.

Offers a practical framework for safety-net health systems to better identify and segment patients with complex needs, and tailor care models to meet their needs.

Step-by-step guide with robust tools for health systems to apply the 4Ms framework to deliver age-friendly, evidence-based care for older adults.

Clinical tools, training resources, and case studies of evidence-based care models that support people living with dementia and their caregivers.