Lower inpatient admissions rates in a transitional care intervention.

Moving patients out of the ED and into community support.

A permanent supportive housing program did not improve most measures related to physical health for individuals experiencing chronic homelessness, but did improve access to and trust in primary care.

Insights from experts, recent research, and state case studies offer actionable recommendations for advancing medically tailored meal initiatives to improve outcomes and reduce costs.

An interdisciplinary, hospital-based addiction medicine consultation team improved substance use disorder treatment engagement after hospitalization.

A tool helps providers capture essential information when interviewing people experiencing unsheltered homelessness to support effective treatment planning.

The benefits of a transitional care program.

Program based in affordable housing sites for older adults and people with disabilities has favorable impact on Medicare and Medicaid expenditures and helps residents remain in community settings.

This toolkit details the benefits of home-based primary care to help providers demonstrate the need for these programs.

How staff composition affects care delivery for older adults.

Nurse practitioners and physician assistants are associated with lower costs.

Supplementing primary care with team-based management.

Staff time effort in complex care coordination programs is highly variable depending on patients’ health and social needs.

Home-based primary care integrated with long-term services and supports in the community can delay long-term institutionalization in frail older adults without increased costs for home- and community-based services.

Shares best practices and screening tool options to identify and care for home-based primary care patients with potential fall risks.

Supportive housing placement for people with substance use disorder (SUD) who are homeless reduces SUD-related health care utilization.

Medication-assisted treatment in correctional settings improves substance use treatment engagement and reduces illicit opioid use post-release.

Medically tailored meals significantly reduced admissions to hospitals and nursing homes for people with complex health and social needs.

Details the main elements of a hospital-based addiction care consultation team.

This resource is an updated quick reference guide to promising models for people with complex needs.