Understanding the values of patients with complex health and social needs can help providers improve care.

Offers practical recommendations to improve telemedicine interventions to be more equitable for diverse populations, particularly those with low incomes.

Contains practical guides, tools, and other resources for developing complex care programs.

Includes patient- and staff-reported measures to help complex care programs better understand the impacts of interventions.

Primary care and alternative payment models that reduce emergency department use and increase access to care for high-need populations share core components for success.

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

An affordable housing program in Baltimore generates between $1.30-$1.92 of “social return” in the community for every dollar invested annually.

Literature review examines the roles and contributions of community health workers in improving dementia care.

Use of machine learning clustering algorithms revealed 30 distinct subgroups of patients among high-risk veterans, indicating a need for tailored approaches to health care.

Discusses the benefits and challenges of tele-social care and offers practical tips for providers administering telehealth services for social care activities.

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.

The Green House model for longer term care residents was associated with reduced COVID-19 death rates compared to traditional nursing homes.

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

Study finds that private equity ownership of skilled nursing facilities leads to a significantly higher average mortality rate for residents.

Describes core competencies that convey the essential knowledge, skills, and attitudes of complex care practitioners and teams to improve care for people with complex needs.

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

Presents tools and tips frontline care management staff to address high-risk patients’ unmet social health needs during the COVID-19 pandemic.

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

Offers a practical framework for safety-net health systems to better identify and segment patients with complex needs, and tailor care models to meet their needs.