Displaying 1 - 19 of 19

How an Interdisciplinary Care Team Reduces Prolonged Admissions Among Older Patients with Complex Needs

An interdisciplinary team approach can improve care coordination and reduce length of hospital stays for older adults with complex health and social needs.

Case Example

August 2021

A Simple Way to Identify Patients Who Need Tech Support for Telemedicine

Describes electronic health record system functionality that automatically identifies patients likely to need technical assistance prior to telehealth visits.

Case Example

August 2021

Return on Health Telehealth: Cityblock Health - Complex Care Coordination

During the COVID-19 pandemic, Cityblock Health implemented a virtually integrated care management model to maintain continuity of care for patients with complex needs.

Case Example

May 2021

“At Home, with Care”: Lessons from New York City Home-Based Primary Care Practices Managing COVID-19

Home-based primary care programs made rapid care delivery adaptations in response to the COVID-19 pandemic, and this flexibility may support new opportunities to care for older, medically complex patients safely in their homes.

Case Example

January 2021

Providing Primary Care to Homebound Patients: UCSF Health's Care at Home Program

This case study highlights an accountable care organization’s home-based primary care program for homebound older adults, with early analysis of outcomes showing reduced acute care utilization.

Case Example

August 2020

Health Care Access Now: Calculating the ROI of a Care Coordination Program to Address Social Determinants of Health

Demonstrating return-on-investment to advance effective business relationships between community-based organizations and health care partners.

Case Example

March 2020

Homage: Calculating the ROI of a Partnership to Meet the Health-Related Social Needs of Medicare Advantage Plan Members

How can a community-based organization demonstrate the two-way financial benefits of partnering with a health plan?

Case Example

March 2020

Great Plains Senior Services Collaborative: Transforming Lives in America’s Rural Communities

A model to improve health and quality of life for rural seniors.

Case Example

July 2019

How a Population-Based Approach Can Improve Dementia Care

Improving Dementia Care

Case Example

May 2019

A New Hospitalist Model for Managing High-Cost, High-Need Patients

A hospitalist model for complex care.

Case Example

October 2018

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.

Case Example

March 2018

Diffusion of Community Health Workers Within Medicaid Managed Care: A Strategy to Address Social Determinants of Health

New Mexico’s model to deploy community health workers is now replicated in 12 states.

Case Example

July 2017

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

March 2017

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

December 2016

Guided Care: A Structured Approach to Providing Comprehensive Primary Care for Complex Patients

Guided Care is designed to strike a balance between telephone-based and interdisciplinary team-based care management programs.

Case Example

October 2016

Aging Gracefully: The PACE Approach to Caring for Frail Elders in the Community

Reviews lessons from the Program of All-Inclusive Care for the Elderly on serving high-need populations in community settings.

Case Example

August 2016

The Hospital at Home Model: Bringing Hospital-Level Care to the Patient

The program offers a lower-cost alternative to the hospital for patients who can be safely treated at home.

Case Example

August 2016

Bringing Primary Care Home: The Medical House Call Program at MedStar Washington Hospital Center

A home-based primary care program decreases costs and utilization for high-risk Medicare enrollees in Washington D.C.

Case Example

July 2016

The Health Resilience Program: A Program Assessment

Health Resilience Specialists work with the patients to meet their personal health needs

Case Example

January 2016

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How an Interdisciplinary Care Team Reduces Prolonged Admissions Among Older Patients with Complex Needs

A Simple Way to Identify Patients Who Need Tech Support for Telemedicine

Return on Health Telehealth: Cityblock Health - Complex Care Coordination

“At Home, with Care”: Lessons from New York City Home-Based Primary Care Practices Managing COVID-19

Providing Primary Care to Homebound Patients: UCSF Health's Care at Home Program

Health Care Access Now: Calculating the ROI of a Care Coordination Program to Address Social Determinants of Health

Homage: Calculating the ROI of a Partnership to Meet the Health-Related Social Needs of Medicare Advantage Plan Members

Great Plains Senior Services Collaborative: Transforming Lives in America’s Rural Communities

How a Population-Based Approach Can Improve Dementia Care

A New Hospitalist Model for Managing High-Cost, High-Need Patients

Complex Care Models to Achieve Accountable Care Readiness: Lessons from Two Community Hospitals

Diffusion of Community Health Workers Within Medicaid Managed Care: A Strategy to Address Social Determinants of Health

CareMore: Improving Outcomes and Controlling Health Care Spending for High-Needs Patients

The Business Case for Community Paramedicine: Lessons from Commonwealth Care Alliance’s Pilot Program

Guided Care: A Structured Approach to Providing Comprehensive Primary Care for Complex Patients

Aging Gracefully: The PACE Approach to Caring for Frail Elders in the Community

The Hospital at Home Model: Bringing Hospital-Level Care to the Patient

Bringing Primary Care Home: The Medical House Call Program at MedStar Washington Hospital Center

The Health Resilience Program: A Program Assessment