Resources

This resource is a guide for payer and provider organizations to invest in social determinants of health (SDOH) and integrate them into their core business model. Few health care organizations have...
Throughout the country, efforts are increasingly emerging to integrate social services into health care systems. This resource classifies new initiatives, identifies common challenges, and proposes...
This resource provides a literature review of existing empirical evidence about the impact of social service interventions on health outcomes and health care spending, based on 39 articles published...
This resource shares 10 questions that California’s Medicaid managed care plans are now required to ask patients about their social and functional needs. These questions could serve as a model for...
This resource provides a summary of key components of the Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act, which was passed and signed on February 9, 2018...
This resource describes observations about root causes of high care utilization that emerged from a four-year intervention in a large population of patients with complex needs. In 2012, Mercy Health...
Since 2015, the Peterson Center on Healthcare has been working to improve the quality and lower the cost of care for high-need, high-cost patients. This resource provides a summary of what has been...
The Massachusetts Health Policy Commission's Community Hospital Acceleration, Revitalization, and Transformation (CHART) investment program has engaged 25 community hospitals to advance readiness for...
This resource is a Disability-Competent Care Self-Assessment Tool. It was developed to help health plans and health systems evaluate their own ability to meet the needs of adults with functional...
This resource describes strategies that health care organizations and plans can use to provide care for patients with serious illness. Palliative care — specialized care that focuses on addressing the...
This resource proposes a Serious Illness Program Design and Implementation Framework (SIP Framework) to guide the development of programs for people with serious illness. The process begins with...
​​​​ This resource describes a program in New Mexico that employs community health workers (CHWs) to address social determinants of health, as well as how that program was implemented and spread. CHWs...