Resources

A telephone-based social needs screening, referral, and navigation program that focused on patients with predicted high utilization within the Kaiser Permanente Southern Cal

Providing supportive housing for individuals experiencing homelessness who are identified as active substance users resulted in lower rates of SUD-related ED visits and hosp

This resource describes a quasi-experimental study evaluating the effect of a transitional care program that involved rapid primary care follow-up

Family caregivers play a foundational role in the care of older adults with complex needs and disabilities from both a health care and economic standpoint.

Family caregivers are a critical part of the home- and community-based workforce for people with serious illness.

This study compared health services use and costs depending on whether the primary care provider was a physician, NP, or PA.

This resource describes and analyzes the different professional compositions of care management programs.

This resource describes and evaluates a new specialist pharmacy service, called the integrated care clinical pharmacist.

At Northwestern Medical Group in Chicago, a patient-centered transitional care intervention serving patients with complex health needs that lack a usual source of care was f

This resource describes a randomized controlled trial to evaluate the effects of a case management intervention called V1SAGES (Vulnerable Patients in Primary Care: Nurse Ca

This resource provides an overview of a quality-improvement intervention focused on communication with patients with advanced cancer. 

This resource describes the 7-Day Pledge program to reduce readmissions by increasing access to timely primary care appointments after hospitalization.