Case Management in Primary Care for Frequent Users of Health Care Services: A Mixed Methods Study
The psychological benefits of case management.
Peer-Reviewed Article
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A case study exploring the effectiveness of an innovative “5Q Care Test” to determine whether patients with complex needs require health or social care
Assessing post-discharge needs.
Peer-Reviewed Article
Experiences of community-dwelling older adults living with multiple chronic conditions: a qualitative study
Challenges and opportunities for older adults with multiple chronic conditions.
Peer-Reviewed Article
Effect of the Serious Illness Care Program in Outpatient Oncology: A Cluster Randomized Clinical Trial
Improving communication with patients with advanced cancer
Peer-Reviewed Article
Outcomes of a Citywide Campaign to Reduce Medicaid Hospital Readmissions with Connection to Primary Care Within 7 Days of Hospital Discharge
The importance of timely primary care follow-up.
Peer-Reviewed Article
Outpatient Complex Case Management: Health System-Tailored Risk Stratification Taxonomy to Identify High-Cost, High-Need Patients
Maximizing the impact of outpatient complex case management.
Peer-Reviewed Article
Impact of a Complex Chronic Care Patient Case Conference on Quality and Utilization
The case conference approach to caring for complex patients.
Peer-Reviewed Article
Systematic Review of High-Cost Patients’ Characteristics and Healthcare Utilisation
An international analysis of high-cost patients.
Peer-Reviewed Article
Engaging High-Need Patients in Intensive Outpatient Programs: A Qualitative Synthesis of Engagement Strategies
Overcoming barriers to patient engagement.
Peer-Reviewed Article
Home and Community-Based Services Coordination for Homebound Older Adults in Home-Based Primary Care
Meeting the needs of older adults who are homebound.
Peer-Reviewed Article
Interventions for Frequently Hospitalized Patients and Their Effect on Outcomes: A Systematic Review
Mixed evidence for efforts to reduce rehospitalizations.
Peer-Reviewed Article
Patient Engagement in ACO Practices and Patient-Reported Outcomes Among Adults with Co-Occurring Chronic Disease and Mental Health Conditions
Patient engagement improves patient-reported outcomes.
Peer-Reviewed Article
Patterns of Collaboration among Health Care and Social Services Providers in Communities with Lower Health Care Utilization and Costs
Community approaches to reducing care utilization and costs.
Peer-Reviewed Article
Going Beyond Clinical Care to Reduce Health Care Spending
A regional approach to health care transformation.
Peer-Reviewed Article
Impact of Primary Care Intensive Management on High-Risk Veterans’ Costs and Utilization
Supplementing primary care with team-based management.
Peer-Reviewed Article
Case Managers for High-Risk, High-Cost Patients as Agents and Street-Level Bureaucrats
How to improve the cost benefits of case management.
Peer-Reviewed Article
Persistence and Drivers of High-Cost Status Among Dual-Eligible Medicare and Medicaid Beneficiaries
Analyzes the largest drivers of high costs among persistently high-cost Medicare-Medicaid beneficiaries, and finds most spending related to long-term care.
Peer-Reviewed Article
Academic Medical Centers and High-Need, High-Cost Patients: A Call to Action
This resource describes how academic medical centers can reshape the health system for patients with complex needs.
Peer-Reviewed Article
Active Redesign of a Medicaid Care Management Strategy for Greater Return on Investment: Predicting Impactability
This resource describes one tool to identify patients most likely to benefit from care management.
Peer-Reviewed Article
Integrating Health Care for High-Need Medicaid Beneficiaries With Serious Mental Illness and Chronic Physical Health Conditions at Managed Care, Provider, and Consumer Levels
This resource describes the value of navigators for Medicaid beneficiaries with mental illness.
Peer-Reviewed Article