Displaying 1 - 20 of 58

Clinical Outcome and Utilization Profiles Among Latent Groups of High-Risk Patients: Moving from Segmentation Towards Intervention

Differing patterns of care utilization and mortality outcomes within subgroups of a complex patient population can help inform more targeted care interventions.

Peer-Reviewed Article

November 2021

Frontline Provider Perceptions of Implementing Home-Based Palliative Care Covered by an Insurer

Home-based palliative care providers explore key facilitators and barriers to effectively delivering care within a value-based payment environment.

Peer-Reviewed Article

November 2021

High-Cost High-Need Patients in Medicaid: Segmenting the Population Eligible for a National Complex Case Management Program

Using segmentation to address clinical and social needs for Medicaid patients with complex needs and costly utilization can improve the effectiveness of complex care programs.

Peer-Reviewed Article

October 2021

The Impact of a Home-Based Palliative Care Program in an Accountable Care Organization

Home-based palliative care program implemented within an accountable care organization created cost savings through reduced hospital admissions and increased hospice length of stay.

Peer-Reviewed Article

September 2021

The Association of Advance Care Planning Documentation and End-of-Life Healthcare Use Among Patients with Multimorbidity

Advance care planning more than one month prior to death is associated with decreased acute care utilization at the end of life and in-hospital death for people with serious illness.

Peer-Reviewed Article

August 2021

Racial Inequality in Prescription Opioid Receipt — Role of Individual Health Systems

Analysis of 310 health systems showed gaps in opioid receipt between Black and white patients, especially on dosage, which may be related to racial bias among clinicians.

Peer-Reviewed Article

July 2021

Use of Latent Class Analysis and k-Means Clustering to Identify Complex Patient Profiles

Creating clinically meaningful profiles of patients with medically complex needs can support the delivery of more tailored interventions.

Peer-Reviewed Article

March 2021

Supporting Acute Advance Care Planning with Precise, Timely Mortality Risk Predictions

Implementing a predictive model in acute settings can more reliably identify patients with high mortality risk, which can assist providers in prioritizing advance care planning.

Peer-Reviewed Article

March 2021

Evidence for the 4Ms: Interactions and Outcomes Across the Care Continuum

The 4Ms approach developed for the Age-Friendly Health System model — what matters, medication, mentation, mobility — has a robust evidence base for providing quality care to older adults.

Peer-Reviewed Article

February 2021

Interventions at Hospital Discharge to Guide Caregivers in Medication Management for People Living with Dementia: A Systematic Review

Medication management interventions that support caregivers of people with dementia at care transitions can help reduce readmissions, caregiver burden, and use of high-risk medication.

Peer-Reviewed Article

February 2021

Implementation of Specialist Palliative Care and Outcomes for Hospitalized Patients with Dementia

Patients with dementia are more likely to be discharged to hospice from hospitals that offer palliative care programs.

Peer-Reviewed Article

February 2021

Money Moves the Mare: The Response of Community‐Based Organizations to Health Care’s Embrace of Social Determinants

Suggests that community-based organizations are responding to Medicaid redesign efforts that prioritize social determinants of health by adopting practices similar to health care organizations.

Peer-Reviewed Article

January 2021

Lessons Learned from the Transition from Volume to Value

Describes factors that support health care organizations in transitioning from volume- to value-based payment.

Peer-Reviewed Article

October 2020

Practice Considerations for Trauma-Informed Care at End of Life

Applying principles of trauma-informed care for patients at end of life.

Peer-Reviewed Article

September 2020

Identifying Populations with Complex Needs: Variation in Approaches Used to Select Complex Patient Populations

Summarizes different approaches and criteria that can be used to identify patients with complex needs for health system interventions.

Peer-Reviewed Article

September 2020

Identifying Patients with Persistent Preventable Utilization Offers an Opportunity to Reduce Unnecessary Spending

Medicare patients with the top five percent in preventable utilization account for almost half of all avoidable Medicare costs.

Peer-Reviewed Article

July 2020

A Beacon for Dark Times: Palliative Care Support During the Coronavirus Pandemic

Hospital system call line expands access to palliative care supports amid COVID-19.

Peer-Reviewed Article

May 2020

Five Strategies to Expand Palliative Care in Safety-Net Populations

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.

Peer-Reviewed Article

March 2020

Potentially Preventable Spending Among High-Cost Medicare Patients: Implications for Healthcare Delivery

Among high-cost Medicare enrollees, those who are seriously ill, frail, and/or had a serious mental illness experience the most potentially preventable spending.

Peer-Reviewed Article

February 2020

Health Care Hotspotting — A Randomized, Controlled Trial

Randomized controlled trial of a care management intervention offers important lessons for the field of complex care.

Peer-Reviewed Article

January 2020

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Clinical Outcome and Utilization Profiles Among Latent Groups of High-Risk Patients: Moving from Segmentation Towards Intervention

Frontline Provider Perceptions of Implementing Home-Based Palliative Care Covered by an Insurer

High-Cost High-Need Patients in Medicaid: Segmenting the Population Eligible for a National Complex Case Management Program

The Impact of a Home-Based Palliative Care Program in an Accountable Care Organization

The Association of Advance Care Planning Documentation and End-of-Life Healthcare Use Among Patients with Multimorbidity

Racial Inequality in Prescription Opioid Receipt — Role of Individual Health Systems

Use of Latent Class Analysis and k-Means Clustering to Identify Complex Patient Profiles

Supporting Acute Advance Care Planning with Precise, Timely Mortality Risk Predictions

Evidence for the 4Ms: Interactions and Outcomes Across the Care Continuum

Interventions at Hospital Discharge to Guide Caregivers in Medication Management for People Living with Dementia: A Systematic Review

Implementation of Specialist Palliative Care and Outcomes for Hospitalized Patients with Dementia

Money Moves the Mare: The Response of Community‐Based Organizations to Health Care’s Embrace of Social Determinants

Lessons Learned from the Transition from Volume to Value

Practice Considerations for Trauma-Informed Care at End of Life

Identifying Populations with Complex Needs: Variation in Approaches Used to Select Complex Patient Populations

Identifying Patients with Persistent Preventable Utilization Offers an Opportunity to Reduce Unnecessary Spending

A Beacon for Dark Times: Palliative Care Support During the Coronavirus Pandemic

Five Strategies to Expand Palliative Care in Safety-Net Populations

Potentially Preventable Spending Among High-Cost Medicare Patients: Implications for Healthcare Delivery

Health Care Hotspotting — A Randomized, Controlled Trial