Interdisciplinary care teams, telehealth, and flexible payment models are included as key recommendations to increase access to home-based primary care in rural communities.

A community health worker-led program for formerly homelessness individuals living in permanent supportive housing increased food security and social connectedness.

The reanalysis of a randomized control trial evaluating the effectiveness of a care management program finds increased linkages to ambulatory care.

A primary care-based integrated care team supports patients with type 1 or type 2 diabetes in reducing A1c levels.

The transition to the Medicaid behavioral health “carve-in” model in Washington State was not associated with significant improvements in overall health outcomes.

An association between Z code assignment and increased emergency and inpatient health care utilization presents opportunities for targeted interventions that address patients' social needs.

California community paramedicine and triage to alternative destination programs lead to more coordinated care and reductions in emergency department visits and hospital readmissions.

Randomized controlled trial shows that a collaborative dementia care model leads to reduction in costs among a sample of Medicare patients.

Curated collection of research studies highlights the efficacy of services provided by community-based organizations, with a focus on outcomes relevant to health care partners.

An interdisciplinary home-based primary care program for older adults with limited mobility leads to reductions in health care utilization and costs.

A primary care practice redesigned its social needs screening and patient triage process to allow specialized staff to spend more time supporting patients with more intensive housing needs.

This resource guide outlines the value case for health plans to partner with community-based organizations for social care benefits.

The community care hub model can support facilitating strong partnerships between community-based organizations and health care organizations.

A program to connect Medicaid ACO enrollees with nutrition and housing-related services demonstrated early indications of effectiveness.

This webinar highlighted one successful CBO-health plan partnership model to explore why they entered into a partnership, how they put their contract into practice, and outcomes of the partnership so far.

Insights from patient-level encounter histories can support optimizing care coordination team staffing for high-need patients.

An overview of NYC Health + Hospital’s implementation of a primary care-based social needs screening and referral program, including key implementation challenges and success factors.

Barriers to community social services to address health-related social needs persist despite screening and referral programs in clinical settings.

Integrated care in MassHealth ACOs varies greatly across primary care practice type and is associated with greater ability to improve care quality and advance health equity.

Randomized controlled trial of a person-centered housing intervention for older adults shows improved health outcomes for formerly homeless adults living in permanent supportive housing.