Accountable care organizations (ACOs) and tailored care coordination strategies may improve preventable hospitalizations and reduce racial disparities among patients with coexisting physical and mental health conditions.
Health homes may increase access to mental health care and substance use disorder treatment in Medicaid enrollees with serious mental illness and/or substance use disorders.
Health care systems may need to tailor screening and referral approaches for social needs, as some needs may be less likely to be met by social service organizations.
Accountable care organizations must address key funding, community partnership, and data sharing requirements to successfully integrate social services into medical care.
Creating a palliative care program to meet the needs of low-income communities requires solutions that are patient centered and supportive of the clinical care team.
Among high-cost Medicare enrollees, those who are seriously ill, frail, and/or had a serious mental illness experience the most potentially preventable spending.
High-need, high-cost older adult patients detail their health care goals, which may inform provider efforts to effectively engage with and care for these patients and their family caregivers.