Resources

This resource describes four care management models that ACOs are using for individuals with complex needs. Care management programs can involve creating patient care plans, coordinating care across...
This resource, the Partnership Evaluation Tool, is intended to help organizations assess readiness to engage in successful value-based partnerships. It can be used to assess potential partners or for...
This resource describes the 7-Day Pledge program to reduce readmissions by increasing access to timely primary care appointments after hospitalization. Previous research suggests the important role of...
This resource offers a variety of materials about “personas” for different segments of the high-need patient population. A persona helps depict the experiences, motivations, and goals of a group of...
Based on a review of the evidence, the Quick Reference Guide to Promising Care Models offers summary information on 28 programs for adults with complex needs, specifically: Target population and...
This resource evaluates the impact of an interprofessional case conference approach in an academic primary care clinic. This study was conducted at a primary care clinic at a VA medical center. The...
This resource provides an evaluation of a health system’s outpatient complex case management (OPCM) program and examines whether OPCM lowers service utilization and health care costs. U.S. health...
This resource assesses the characteristics and health care utilization of high-cost patients and compares high-cost patients across payers and countries, based on a systematic review of studies in...
This resource identifies features of intensive outpatient programs that increase patient engagement. Program leaders and clinicians from 12 intensive outpatient programs responded to a questionnaire...
This resource describes the strategies employed by ACOs that have comprehensive care management programs for complex patients. This report is from the six-foundation collaborative and is based on...
This resource reviews interventions for frequently hospitalized patients and assesses the effectiveness of these interventions. Health care organizations have begun to implement interventions that...
This resource curates resources from experts across the country in the field of trauma-informed care. Health care stakeholders are increasingly recognizing the impact of trauma on health and the value...