Building Complex Care Programs: A Road Map for States This guide for state leaders offers lessons about state-level approaches to complex care. Implementation Tool October 2017
Care Management Contracting for Complex Populations: Best Practices and Tools This resource offers guidance on contracting for populations with complex needs. Implementation Tool July 2018
Investing in Social Services as a Core Strategy for Healthcare Organizations: Developing the Business Case This resource explains how to invest in social services as a business strategy. Implementation Tool March 2018
Strengthening Medicaid Long-Term Services and Supports: A Toolkit for States This resource explains how states can improve their Medicaid LTSS systems. Implementation Tool March 2019
Accountable Care Atlas: A Development Guide for Competency Implementation This resources describes the competencies organizations need to transition to value-based payment. Implementation Tool November 2017
Disability-Competent Care Self-Assessment Tool How disability-competent is your organization? Implementation Tool October 2017
Multiple Chronic Conditions: A Framework for Education and Training A framework describes how to train the health care workforce to care for people with multiple chronic conditions. Implementation Tool June 2015
Serious Illness Conversation Guide This conversation guide includes specific steps and language for talking about serious illness. Implementation Tool July 2017
Intensive Outpatient Care Program Toolkit The staff position of care coordinator is crucial to success. Implementation Tool December 2016
Overview of Segmentation of High-Need, High-Cost Patient Population There are many promising strategies to segment individuals with complex needs. Here is one conceptual framework. Implementation Tool January 2016
The Care Transitions Intervention The Care Transitions Intervention was co-designed with patients and evaluated using randomized trials. Implementation Tool November 2016
Emergency Department Super-Utilizer Programs: Rural Health Systems Analysis and Technical Assistance Project This guide describes how to design, implement, and assess a program to reduce preventable ED use. Implementation Tool October 2013
Improving Care for People with Serious Illness Through Innovative Payer-Provider Partnerships The benefits of, incentives for, and various models to deliver palliative care are described. Implementation Tool January 2014
The Return on Investment (ROI) Calculator: The Business Case and Person-Centered Care A calculator that can help build and present business case for serving adults with complex needs. Implementation Tool November 2016
Pursuing Financial Sustainability of Person-Centered Care Models Setting up data collection systems is important to showing value. Implementation Tool January 2014
Complex Care Management Toolkit Lessons learned from eight health care organizations can help you design a successful program. Implementation Tool April 2012