This resource explains how states can improve their Medicaid LTSS systems.

An in-depth overview of different personas.

Medicare Advantage plans should identify patients based on medical and social risk factors, not just medical diagnoses.

This resource is an updated quick reference guide to promising models for people with complex needs.

Video series details how health systems can redesign primary care, including through home-based primary care programs, to better meet the needs of people with disabilities.

Case study explores the unique structure of Washington State’s demonstration under the federal Financial Alignment Initiative, including summary of results to date.

Multiple factors, including geographic variation in available resources, may limit take-up among MA plans of new benefit flexibilities.

Accountable Care Organization leaders explore approaches to segmenting high-need, high-cost populations.

Fostering a culture of caring for veterans takes interdisciplinary teams focused on comprehensive, trusting and reliable relationships through open and frequent communication and ongoing education.

Provides lessons on the function and impact of health plan Consumer Advisory Councils from Medicare-Medicaid Plans in capitated model demonstrations under the Financial Alignment Initiative.

Idaho's innovative Medicare Medicaid Coordinated Plan offers valuable lessons for states nationwide.

Predictive modeling to reduce ED utilization.

Telehealth interventions had similar outcomes to in-person care for different services and populations, but did not consistently impact utilization such as physician or emergency department visits.

This resource outlines the current state of complex care and recommendations for the future.

An analysis of the National Survey of ACOs

Mixed evidence for efforts to reduce rehospitalizations.

This resource describes how academic medical centers can reshape the health system for patients with complex needs.

Maximizing the impact of outpatient complex case management.

Analyzes the largest drivers of high costs among persistently high-cost Medicare-Medicaid beneficiaries, and finds most spending related to long-term care.

A hospitalist model for complex care.