Profiles the Care Ecosystem program, developed at the University of California, San Francisco, that is using care team navigators to support older adults with dementia who are living at home and their caregivers.

Profiles the Rush Caregiver Intervention at Rush University Medical Center, that is working to transform how the health care system interacts with family caregivers, while providing programs and services that support caregivers and their family members.

Profiles Landmark Health, company to bring comprehensive care to the homes of older adult patients with multiple chronic conditions.

Profiles CAPABLE, is a participant-driven model that improves function by addressing the home environment and using the strengths of the older adults themselves.

Details a partnership between Commonwealth Care Alliance, a non-profit community-based payer and provider serving people with significant needs, and Hearth, a non-profit community-based organization focused on ending elder homelessness, to provide permanent supportive housing for eligible individuals.

Features Housecall Providers, a non-profit medical provider serving Portland, Oregon, offering comprehensive home- and community-based programs that incorporate palliative care services and provide patient-driven, high-touch support wherever patients call home.

Highlights Cleveland Clinic's Paramedic Telehealth Program that provides urgent and transitional care for home-based primary care patients.

Details the elements of Rush@Home’s care model and shares the impact and insights from implementing this home-based primary care program.

Health Quality Partners shares lessons for other organizations that may be interested in implementing complex care programs.

CommonSpirit Health share their insights about the process of implementing social needs screening and integrating community health workers into care.

Leadership from the California Community Foundation and Southside Coalition of Community Health Centers explore their health information exchange pilot.