Evaluates the evidence on interventions for people living with dementia, their care partners, and caregivers to help identify what interventions are ready for broad implementation.

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.

Provides an overview of home-based medical care models, the patients that they serve, and their robust evidence base.

Health care organizations can use population-level data sources about the experiences of people with disabilities to improve care.

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

This case study highlights an accountable care organization’s home-based primary care program for homebound older adults, with early analysis of outcomes showing reduced acute care utilization.

How can a community-based organization demonstrate the two-way financial benefits of partnering with a health plan?

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

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

A unique cross-sector partnership involving health care, police, and emergency services improved health care utilization in this rural health system pilot.

When identifying patients with complex health needs for interventions, algorithms that rely on cost data as a proxy for health status may lead to under-identification of Black patients.

Recommendations for integrating social and health care to improve the nation’s health.

How ACOs are addressing serious illness.

Includes national survey data on family caregivers and their experiences in managing complex medical and nursing tasks for their family members at home, as well as recommendations to improve the supports for family caregivers.

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

An analysis of the National Survey of ACOs

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 describes how MA could lead the way in diffusing new care and payment models.

A brief summarizes what you need to know about the new Chronic Care Act.

Case studies of two community hospitals show how to advance accountable care.