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.
Demonstrates that intensive outpatient care programs show promise in reducing utilization and costs and improving patient outcomes for high-need, high-cost populations.
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.
Integrated health care systems can better support high-risk patients by embedding high-risk patient care within general primary care and mental health care.
Toolkit offers health care stakeholders in rural areas with practical information to support the design, implementation, and evaluation of community paramedicine programs.
Accountable care organizations (ACOs) and tailored care coordination strategies may improve preventable hospitalizations and reduce racial disparities among patients with coexisting physical and mental health conditions.
Health care systems may need to tailor screening and referral approaches for social needs, as some needs may be less likely to be met by social service organizations.