Described how health care organizations and community-based organizations can use the ROI Calculator to explore and plan financial arrangements to fund social services for people with complex needs.

AAAs and other community-based organizations can take key steps to improve their capacity for cross-sector partnerships to address health-related social needs of older adults.

Interdisciplinary primary care models can help reduce acute care use for individuals with histories of high emergency department use, homelessness, or substance use disorder.

Permanent supportive housing shows mixed results in improving health outcomes and health care costs for people experiencing chronic homelessness.

The economic benefits of permanent supportive housing programs with a Housing First approach exceed the costs in the U.S., with a benefit-to-cost ratio of 1.8:1.

Permanent supportive housing programs with a “Housing First” approach can improve health outcomes and reduce acute care use for people experiencing homelessness with disabling conditions.

Varying structures of cross-sector partnerships between health care organizations, social service agencies, and local government bodies have distinct strengths and serve different functions.

Accountable care organization leaders share perspectives on payment mechanisms used with social service organizations, challenges experienced, and the impacts of these partnerships.

Using segmentation to address clinical and social needs for Medicaid patients with complex needs and costly utilization can improve the effectiveness of complex care programs.

Systematic review of programs to improve care for patients with complex needs details evidence base across multiple settings.

Global budgets for hospitals reduced expenditures and utilization for some Medicare subpopulations with complex health and social needs, yet disparities existed for some subgroups.

These resources can help nurses educate and support family caregivers in performing complex medical tasks for their family members at home.

Explored how complex care stakeholders can incorporate a multi-factor approach to measure and demonstrate the value of complex care programs for diverse stakeholders.

In nursing homes, replacing on-call physician services during off-hours with direct contact via telemedicine may reduce Medicare spending through fewer avoidable hospitalizations.

Telehealth interventions had similar outcomes to in-person care for different services and populations, but did not consistently impact utilization such as physician or emergency department visits.

Offers practical recommendations to improve telemedicine interventions to be more equitable for diverse populations, particularly those with low incomes.

Describes electronic health record system functionality that automatically identifies patients likely to need technical assistance prior to telehealth visits.

Discusses the benefits and challenges of tele-social care and offers practical tips for providers administering telehealth services for social care activities.

For people with disabilities, familiarity with their care teams and care plans, and increased access to long-term services and supports can improve their perceptions of quality of life and health care.

This toolkit can support health care organizations in creating the business case for complex care programs.