A machine learning model helped identify primary care patients with major depression who are at high risk of frequent emergency department use and might benefit from collaborative care management.

This toolkit details options for implementing recently introduced Medicare services that address members’ health-related social needs.

This webinar described how the Camden Coalition has refined and expanded programs in recent years to more effectively care for adults with complex health and social needs and integrate lessons from this evidence.

Interdisciplinary care teams, telehealth, and flexible payment models are included as key recommendations to increase access to home-based primary care in rural communities.

Evaluation of a diabetes-focused medically tailored meals pilot demonstrates improved health outcomes and provides examples of key implementation tools.

Nurse assessments of discharge readiness for older patients with multiple chronic conditions can help identify patients at high risk for hospital readmission.

Report and companion case studies share strategies to support community health centers and federal and state policymakers in increasing the use of medications for opioid use disorder.

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

Evidence-based federal policy recommendations seek to strengthen the integrated care workforce.

A primary care-based integrated care team supports patients with type 1 or type 2 diabetes in reducing A1c levels.

Multidisciplinary integrated practice units may have a greater impact on acute care utilization by focusing on patients who have high utilization of emergency departments and are uninsured.

Report summarizes the evidence on outcomes for patients participating in various telehealth delivered services, including different modalities, such as telephone and video.

California community paramedicine and triage to alternative destination programs lead to more coordinated care and reductions in emergency department visits and hospital readmissions.

Toolkit offers health care stakeholders interested in working with community members guidance on equitable compensation strategies.

This resource center offers guidance to help Medicaid stakeholders engage community members in policy and program design development, especially as a means of increasing health equity.

Evaluation of North Carolina’s updated Medicaid telehealth policies demonstrate that strategies are needed to address racial disparities in telehealth use and promote more equitable access.

Secondary analysis of Camden Coalition randomized controlled data found that care management participants who were the most likely to engage with the intervention had significantly lower readmission rates.

An interdisciplinary care management program for Medicare patients at increased risk of hospitalization demonstrates a positive return on investment.

Randomized controlled trial shows that a collaborative dementia care model leads to reduction in costs among a sample of Medicare patients.

Curated collection of research studies highlights the efficacy of services provided by community-based organizations, with a focus on outcomes relevant to health care partners.