Analysis of street medicine programs reveals differences in behavioral health services across programs, highlighting key facilitators and challenges to better integration of these services within street medicine.

A primary care practice redesigned its social needs screening and patient triage process to allow specialized staff to spend more time supporting patients with more intensive housing needs.

Insights from patient-level encounter histories can support optimizing care coordination team staffing for high-need patients.

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.

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.

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

Toolkit provides best practices and practical tools for designing, implementing, and evaluating the impact of community health workers.

Clients enrolled in an adapted assertive community treatment model in California identify material resources and relational supports as key program benefits.

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

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 managers noted establishing trust, fostering mindset changes, and increasing stability and independence can be measures of success when working with people with complex needs.

Report explores the definition and components of street medicine and outreach, as well as provides best practices for delivering this type of care.

A short-term emergency department navigator program helped address acute care utilization for individuals with low baseline utilization through primary care follow up appointments and assistance with social needs.

Medicaid enrollees in a community health worker program had fewer emergency department visits and more outpatient ambulatory care use than beneficiaries who received usual care.

Shared practical implementation considerations that can support health plans and provider groups in developing community-based models of care that use the strengths of social workers and community health workers.

Resources to help organizations plan and implement medical respite care programs, including program development guides, case examples, and implementation tools.

State investments in enhanced primary care for older and chronically ill individuals recently released from incarceration yielded a $2.55 return on investment for Medicaid and criminal justice combined.

A hospital-based program showed that peer recovery coaching can be seamlessly integrated into the workflow of busy emergency departments to address the longer-term needs of people with substance use disorders.