This study examined five programs that serve patients with complex needs through medical and non-medical services.
- Authors created a framework to illustrate the foundational factors that encourage effective collaboration, including flexible financing, shared leadership, shared data, and a commitment to person-centered care.
- The five programs represented diversity in geography and patient population, but all shared a commitment to person-centered care, namely through addressing social needs as well as medical needs.
- In all of the programs, the health center served as the convening group among various services and the source of funds.
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Adults Under 65 with Disabilities
Frail Older Adults
People with Multiple Chronic Conditions
People with Behavioral Health and Social Needs
Key Questions Answered
- How are innovative programs bridging the silos between medical and non-medical services to better serve people with complex needs?
- What are the attributes of these programs that facilitate collaboration across services and organizations?
Level of Evidence
PromisingWhat does this mean?