Resources

This resource describes a study assessing the effects of patient activation and engagement strategies on patient-reported outcomes for patients with diabetes and/or cardiovascular and comorbid mental...
This resource describes a study of how health care providers and social services providers coordinate their work in communities that achieve relatively low health care utilization and costs for older...
Aligning quality improvement is a key principle of the Special Needs Plan Alliance and its member health plans. One health plan that has been working toward such alignment in an innovative way for several years is Senior Whole Health, part of the Magellan system, located in Massachusetts. Recently, Deborah Paone sat down with Andrew McClure of Senior Whole Health, a Magellan company, to discuss his work around aligning quality measurement and improvement. Andrew also presented this information at the Special Needs Plan Alliance Executive Forum in October 2018. This blog post offers insight from Andrew on what they did and what drove the success of this partnership between medical group providers and this special needs health plan.
On February 9, 2018, Congress passed and the President signed into law the Bipartisan Budget Act of 2018. Title III of this legislation contained a series of landmark provisions for advancing the integration of Medicare and Medicaid and for improving care for persons with complex chronic conditions. In this post, Rich Bringewatt, President and CEO of the National Health Policy Group describes the implications of this new law.
A new care delivery model of providing hospital-level services in the home (sometimes referred to as “home hospitalization” or “hospital at home”) has been launching with pilots at a number of health systems nationally.
This resource describes a randomized quality improvement trial that assessed whether augmenting usual primary care with team-based intensive management lowers utilization and costs for high-risk...
This resource reviews the literature on case management programs published over the past 17 years, arguing that application of two theories (agency and street-level bureaucratic theory) can help...
On October 30, 2018, the Playbook convened a panel of leading complex care experts to address emerging best practices related to financing a complex care model. They addressed the following questions...
When individuals participate in both Medicare and Medicaid, it would be ideal for them to be enrolled in one plan that integrates both programs and coordinates the benefits. And in some cases, this is already happening. But too often, these individuals—who are already highly vulnerable—are enrolled in entirely different, uncoordinated plans for each program. This further complicates an already fragmented delivery system for this high-needs group.
Catherine Mather, Institute for Healthcare Improvement We all know that the emergency department is the simplest, most relaxed place in a hospital. Given this, it should be easy to treat and refer patients with substance abuse disorder, right? Of course not! In fact, it’s so complex that I have yet to find any U.S. hospital that allows patients to be identified, treated, and transferred with any degree of consistency and predictability. But it can be done. To start, let’s walk through some of the four barriers that I hear most often, and talk about how to address them. Once you’re ready to get...
Integrating social workers into primary care teams can help improve patients’ health by proactively addressing their social determinants of health and mental health needs. This integration also reduces the burden on providers and helps organizations to reach their institutional quality goals. By using patient and family engagement techniques, leveraging community-based supports, and coordinating care, social workers can improve patient self-management and ensure that psychosocial factors that influence health are addressed. To achieve and sustain successful outcomes, these initiatives should...
This resource analyzes the drivers of cost for Medicare-Medicaid beneficiaries, particularly looking at the differences between persistent and transient high costs. We know surprisingly little about...