Displaying 1 - 20 of 56

The Camden Coalition Care Management Program Improved Intermediate Care Coordination: A Randomized Controlled Trial

The reanalysis of a randomized control trial evaluating the effectiveness of a care management program finds increased linkages to ambulatory care.

Peer-Reviewed Article

December 2023

The Return on Investment (ROI) Calculator for Healthcare Partnerships to Address Social Needs

This tool can support health care and community-based organizations in building sustainable cross-sector partnerships.

Implementation Tool

October 2023

Assessment of the Massachusetts Flexible Services Program to Address Food and Housing Insecurity in a Medicaid Accountable Care Organization

A program to connect Medicaid ACO enrollees with nutrition and housing-related services demonstrated early indications of effectiveness.

Peer-Reviewed Article

June 2023

Estimating the Workload of a Multi-Disciplinary Care Team Using Patient-Level Encounter Histories

Insights from patient-level encounter histories can support optimizing care coordination team staffing for high-need patients.

Peer-Reviewed Article

June 2023

Scaling Primary Care Social Needs Screening and Referrals in New York City’s Safety-Net Health System

An overview of NYC Health + Hospital’s implementation of a primary care-based social needs screening and referral program, including key implementation challenges and success factors.

Case Example

June 2023

Integration on the Frontlines of Medicaid Accountable Care Organizations and Associations with Perceived Care Quality, Health Equity, and Satisfaction

Integrated care in MassHealth ACOs varies greatly across primary care practice type and is associated with greater ability to improve care quality and advance health equity.

Peer-Reviewed Article

May 2023

Community Health Worker Programs

Curates recent evidence behind community health worker programs that support people with complex health and social needs, as well as practical strategies to support effective implementation of these programs.

Collection

April 2023

Community Health Worker Model Best Practice Toolkit for Designing, Implementing and Showing Impact

Toolkit provides best practices and practical tools for designing, implementing, and evaluating the impact of community health workers.

Implementation Tool

March 2023

Results of a Peer Navigator Program to Address Chronic Illness Among Persons Experiencing Homelessness

Embedded peer navigators provide support and mentorship for people experiencing homelessness, leading to increases in chronic disease screening and referrals.

Peer-Reviewed Article

February 2023

Guide to Evidence for Health-Related Social Needs Interventions: 2022 Update

Summarizes evidence on costs of health-related social needs interventions and their impact on utilization and cost of care to inform ROI Calculator users.

Implementation Tool

September 2022

Integrating Spiritual Care in Population Health and Care Management: Two Case Examples

Including spiritual care within care management programs in outpatient, managed care, and population health settings can enhance patient care and support the effectiveness of the interdisciplinary care team.

Case Example

September 2022

High Touch, High Trust: Using Community Health Advocates and Lawyers to Address ED High Utilizers

Social and legal services to address health care costs and utilization may be most effective for individuals with moderately high utilization who are less clinically complex.

Peer-Reviewed Article

July 2022

Defining Case Management Success: A Qualitative Study of Case Manager Perspectives from a Large-Scale Health and Social Needs Support Program

Case managers noted establishing trust, fostering mindset changes, and increasing stability and independence can be measures of success when working with people with complex needs.

Peer-Reviewed Article

June 2022

State of the Science on Social Screening in Healthcare Settings

Summarizes research on the prevalence of social screening in health care settings, validity of social screening tools, and patient and provider perspectives on social screening.

Brief/Report

June 2022

Applying the ROI Calculator for Partnerships to Address Social Determinants of Health

Described how health care organizations and community-based organizations can use the ROI Calculator to explore and plan financial arrangements to fund social services for people with complex needs.

Webinar

May 2022

Housing and Health

Curates recent evidence behind housing programs and interventions, and explores practical tools and case studies on effective strategies for improving the health of people experiencing homelessness or unstable housing.

Collection

April 2022

Gap in Willingness and Access to Video Visit Use Among Older High-Risk Veterans: Cross-Sectional Study

With the steep increase in use of telehealth and video visits in the last few years, the reliance on technology-enabled medicine may heighten disparities in health care access.

Peer-Reviewed Article

April 2022

Medical Respite Care Tool Kit

Resources to help organizations develop and improve medical respite programs for people experiencing homelessness.

Implementation Tool

April 2022

Mechanisms for Community Health Worker Action on Patient-, Institution-, and Community-Level Barriers to Primary Care in a Safety-Net Setting

Patients and community health workers (CHWs) share perspectives on the impact of CHW services provided within a primary care setting to address barriers to equitable care.

Peer-Reviewed Article

January 2022

Implementation and 12-Month Health Service Utilization and Cost Outcomes from a Managed Care Health Plan's Permanent Supportive Housing Program

Study details permanent supportive housing program implementation and how this impacts outcomes and costs.

Brief/Report

December 2021

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The Camden Coalition Care Management Program Improved Intermediate Care Coordination: A Randomized Controlled Trial

The Return on Investment (ROI) Calculator for Healthcare Partnerships to Address Social Needs

Assessment of the Massachusetts Flexible Services Program to Address Food and Housing Insecurity in a Medicaid Accountable Care Organization

Estimating the Workload of a Multi-Disciplinary Care Team Using Patient-Level Encounter Histories

Scaling Primary Care Social Needs Screening and Referrals in New York City’s Safety-Net Health System

Integration on the Frontlines of Medicaid Accountable Care Organizations and Associations with Perceived Care Quality, Health Equity, and Satisfaction

Community Health Worker Programs

Community Health Worker Model Best Practice Toolkit for Designing, Implementing and Showing Impact

Results of a Peer Navigator Program to Address Chronic Illness Among Persons Experiencing Homelessness

Guide to Evidence for Health-Related Social Needs Interventions: 2022 Update

Integrating Spiritual Care in Population Health and Care Management: Two Case Examples

High Touch, High Trust: Using Community Health Advocates and Lawyers to Address ED High Utilizers

Defining Case Management Success: A Qualitative Study of Case Manager Perspectives from a Large-Scale Health and Social Needs Support Program

State of the Science on Social Screening in Healthcare Settings

Applying the ROI Calculator for Partnerships to Address Social Determinants of Health

Housing and Health

Gap in Willingness and Access to Video Visit Use Among Older High-Risk Veterans: Cross-Sectional Study

Medical Respite Care Tool Kit

Mechanisms for Community Health Worker Action on Patient-, Institution-, and Community-Level Barriers to Primary Care in a Safety-Net Setting

Implementation and 12-Month Health Service Utilization and Cost Outcomes from a Managed Care Health Plan's Permanent Supportive Housing Program