Displaying 21 - 40 of 101

Partnerships with Community-Based Organizations: Opportunities for Health Plans to Create Value

This resource guide outlines the value case for health plans to partner with community-based organizations for social care benefits.

Implementation Tool

June 2023

Functions of a Mature Community Care Hub

The community care hub model can support facilitating strong partnerships between community-based organizations and health care organizations.

Implementation Tool

June 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

Addressing the Complex Needs of Older Adults through Strong Community-Based Organization and Health Plan Partnerships

This webinar highlighted one successful CBO-health plan partnership model to explore why they entered into a partnership, how they put their contract into practice, and outcomes of the partnership so far.

Webinar

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

Supporting Food & Nutrition Security Through Healthcare

A guide for health care organizations on evidence-based strategies to implement food and nutrition security programs.

Brief/Report

June 2023

Addressing Health-Related Social Needs Via Community Resources: Lessons From Accountable Health Communities

Barriers to community social services to address health-related social needs persist despite screening and referral programs in clinical settings.

Peer-Reviewed Article

May 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

A Pilot Randomized Controlled Trial of CAPABLE in Permanent Supportive Housing for Formerly Homeless Adults

Randomized controlled trial of a person-centered housing intervention for older adults shows improved health outcomes for formerly homeless adults living in permanent supportive housing.

Peer-Reviewed Article

April 2023

Community Health Worker Programs in Primary Care

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 Integration with and Effectiveness in Health Care and Public Health in the United States

Community health worker interventions are effective for improving health behaviors and outcomes and reducing health care costs for people with chronic disease.

Peer-Reviewed Article

April 2023

Lifting the Veil How Networks Form Operate Struggle and Succeed

This report highlights challenges of network-based contracting between health care entities and community-based organizations and shares tips for successful implementation.

Brief/Report

April 2023

Easy to Use and Validated Predictive Models to Identify Beneficiaries Experiencing Homelessness in Medicaid Administrative Data

A validated predictive model for health care stakeholders to better identify and address homelessness and its related outcomes.

Peer-Reviewed Article

February 2023

The Role of Community Health Workers in the Health and Well-Being of Vulnerable Older Adults During the COVID-19 Pandemic

A telephone-based community health worker program offered critical supports for older adults during the COVID-19 pandemic.

Peer-Reviewed Article

February 2023

Observational Analysis of a Generalized, Health Plan-led Community Health Worker Intervention in Medicaid

Medicaid health plan-led community health worker program showed moderate evidence for increased outpatient care and primary care use.

Peer-Reviewed Article

January 2023

Association of National Expansion of Insurance Coverage of Medically Tailored Meals with Estimated Hospitalizations and Health Care Expenditures in the US

Simulation model estimates that national implementation of medically tailored meal programs for specific populations would achieve over $13.6 billion in cost savings per year.

Peer-Reviewed Article

October 2022

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

Prediction of Future Health Care Utilization Through Note-Extracted Psychosocial Factors

Natural language processing of patient visit notes can help providers identify social factors that may lead to health care utilization for older adults with multiple chronic conditions.

Peer-Reviewed Article

June 2022

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Partnerships with Community-Based Organizations: Opportunities for Health Plans to Create Value

Functions of a Mature Community Care Hub

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

Addressing the Complex Needs of Older Adults through Strong Community-Based Organization and Health Plan Partnerships

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

Supporting Food & Nutrition Security Through Healthcare

Addressing Health-Related Social Needs Via Community Resources: Lessons From Accountable Health Communities

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

A Pilot Randomized Controlled Trial of CAPABLE in Permanent Supportive Housing for Formerly Homeless Adults

Community Health Worker Programs in Primary Care

Community Health Worker Integration with and Effectiveness in Health Care and Public Health in the United States

Lifting the Veil How Networks Form Operate Struggle and Succeed

Easy to Use and Validated Predictive Models to Identify Beneficiaries Experiencing Homelessness in Medicaid Administrative Data

The Role of Community Health Workers in the Health and Well-Being of Vulnerable Older Adults During the COVID-19 Pandemic

Observational Analysis of a Generalized, Health Plan-led Community Health Worker Intervention in Medicaid

Association of National Expansion of Insurance Coverage of Medically Tailored Meals with Estimated Hospitalizations and Health Care Expenditures in the US

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

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

Prediction of Future Health Care Utilization Through Note-Extracted Psychosocial Factors