Complex Care Models to Achieve Accountable Care Readiness: Lessons from Two Community Hospitals
Case studies of two community hospitals show how to advance accountable care.
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Displaying 281 - 300 of 326
Care Ecosystem Toolkit
Details implementation guidance for the evidence-based Care Ecosystem model, which improves supports for people with dementia and their caregivers.
Implementation Tool
Operation and Challenges of Home-Based Medical Practices in the US: Findings from Six Aggregated Case Studies
Strategies for home-based primary care practices to improve efficiency and support program growth based on qualitative research.
Peer-Reviewed Article
Experiences of Three States Implementing the Medicaid Health Home Model to Address Opioid Use Disorder — Case Studies in Maryland, Rhode Island, and Vermont
Qualitative study highlights success factors and implementation challenges for state opioid health home programs.
Peer-Reviewed Article
What Works in Integrated Care Programs for Older Adults with Complex Needs? A Realist Review
A literature review describes the most important success factors for integrated care programs.
Peer-Reviewed Article
Community Health Worker Support for Disadvantaged Patients with Multiple Chronic Diseases: A Randomized Clinical Trial
This resource describes the benefits of community health workers for people with multiple chronic conditions.
Peer-Reviewed Article
Effective Care for High-Need Patients: Opportunities for Improving Value, Outcomes and Health
The National Academy of Medicine offers a synthesis of the evidence for improving care for high-needs patients.
Brief/Report
Integrating Health Care for High-Need Medicaid Beneficiaries With Serious Mental Illness and Chronic Physical Health Conditions at Managed Care, Provider, and Consumer Levels
This resource describes the value of navigators for Medicaid beneficiaries with mental illness.
Peer-Reviewed Article
Evaluation of the Medicaid Health Home Option for Beneficiaries with Chronic Conditions: Evaluation of Outcomes of Selected Health Home Programs, Annual Report - Year Five
Evaluation of state Medicaid health home model programs details approaches for implementation and outcomes for enrolled members.
Brief/Report
Caregiver Integration during Discharge Planning of Older Adults to Reduce Resource Utilization: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Including caregivers in the discharge planning process reduces the risk of hospital readmission for older adults.
Peer-Reviewed Article
Preventing Hospitalization with Veterans Affairs Home-Based Primary Care: Which Individuals Benefit Most?
Home-based primary care program reduced hospitalizations for older adults with diabetes, especially those with higher levels of medical complexity.
Peer-Reviewed Article
CareMore: Improving Outcomes and Controlling Health Care Spending for High-Needs Patients
CareMore’s business model identifies high-risk patients and surrounds them with coordinated services
Case Example
Innovative Home Visit Models Associated with Reductions in Costs, Hospitalizations, and Emergency Department Use
Home visits can reach patients with complex needs before a higher level of care is needed
Peer-Reviewed Article
Complex Care Program Development: A New Framework for Design and Evaluation
A new framework outlines four steps to develop care management programs.
Brief/Report
The Business Case for Community Paramedicine: Lessons from Commonwealth Care Alliance’s Pilot Program
Cost considerations for the expansion of mobile integrated health care and community paramedicine programs.
Case Example
Intensive Outpatient Care Program Toolkit
The staff position of care coordinator is crucial to success.
Implementation Tool
Care Management Plus: Strengthening Primary Care for Patients with Multiple Chronic Conditions
A program to help clinics deliver comprehensive care may decrease mortality and hospitalization rates.
Case Example
The Care Transitions Intervention
The Care Transitions Intervention was co-designed with patients and evaluated using randomized trials.
Implementation Tool
Reduced Emergency Room and Hospital Utilization in Persons with Multiple Chronic Conditions and Disability Receiving Home-Based Primary Care
People with multiple chronic conditions and disabilities enrolled in home-based primary care experienced persistent reduced acute care utilization.
Peer-Reviewed Article
Hennepin Health: A Care Delivery Paradigm for New Medicaid Beneficiaries
By closing gaps in care, a safety-net ACO has reduced medical costs for Medicaid patients with complex needs.
Case Example