Ten Questions to Better Understand and Serve Your Complex Care Population California is asking Medicaid patients these ten questions about social and functional needs. Brief/Report April 2018
The CHRONIC Care Act of 2018: Advancing Care for Adults with Complex Needs A brief summarizes what you need to know about the new Chronic Care Act. Brief/Report March 2018
Investing in Social Services as a Core Strategy for Healthcare Organizations: Developing the Business Case This resource explains how to invest in social services as a business strategy. Implementation Tool March 2018
Complex Care Models to Achieve Accountable Care Readiness: Lessons from Two Community Hospitals Case studies of two community hospitals show how to advance accountable care. Case Example March 2018
Care Ecosystem Toolkit Details implementation guidance for the evidence-based Care Ecosystem model, which improves supports for people with dementia and their caregivers. Implementation Tool February 2018
Development of a Care Guidance Index Based on What Matters to Patients The What Matters Index measures quality of life for people with chronic conditions. Peer-Reviewed Article January 2018
Using Community Partnerships to Integrate Health and Social Services for High-Need, High-Cost Patients This brief describes new ways for health care to address social determinants of health. Brief/Report January 2018
Laying the Groundwork for Trauma-Informed Care How organizations can transition to trauma-informed care. Brief/Report January 2018
Accountable Care Atlas: A Development Guide for Competency Implementation This resources describes the competencies organizations need to transition to value-based payment. Implementation Tool November 2017
Building Complex Care Programs: A Road Map for States This guide for state leaders offers lessons about state-level approaches to complex care. Implementation Tool October 2017
Designing a Health Care System for Patients with Complex Needs: Ten Recommendations for Policymakers An international expert group offers ten policy recommendations and profiles of innovative care models. Brief/Report September 2017
Compendium of Five Case Studies: Lessons for Interprofessional Teamwork The VA shares lessons on workforce learning and development. Brief/Report September 2017
Case Managers for High-Risk, High-Cost Patients as Agents and Street-Level Bureaucrats How to improve the cost benefits of case management. Peer-Reviewed Article August 2017
Diffusion of Community Health Workers Within Medicaid Managed Care: A Strategy to Address Social Determinants of Health New Mexico’s model to deploy community health workers is now replicated in 12 states. Case Example July 2017
Effective Care for High-Need Patients: Opportunities for Improving Value, Outcomes and Health The National Academy of Medicine offers a synthesis of the evidence for improving care for high-needs patients. Brief/Report June 2017
Integrating Health Care for High-Need Medicaid Beneficiaries With Serious Mental Illness and Chronic Physical Health Conditions at Managed Care, Provider, and Consumer Levels This resource describes the value of navigators for Medicaid beneficiaries with mental illness. Peer-Reviewed Article June 2017
Competing Health Care Systems and Complex Patients: An Inter-Professional Collaboration This paper describes competing health care systems can collaborate to improve care for overlapping patient populations. Peer-Reviewed Article June 2017
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
Improving Care for High-Need, High-Cost Medicare Patients This Bipartisan Policy Center report makes policy recommendations to allow Medicare to pay for non-medical supports and services. Brief/Report April 2017
State Strategies: Value-Based Payment for Medicaid Populations with Complex Care Needs This brief describes Medicaid payment reform strategies for long-term services and support. Brief/Report April 2017