Offers a practical framework for safety-net health systems to better identify and segment patients with complex needs, and tailor care models to meet their needs.

Provides an overview of home-based medical care models, the patients that they serve, and their robust evidence base.

Includes promising practices, recommendations, vignettes, and other helpful tools to assist health systems in supporting family caregivers providing complex care.

Describes factors that support health care organizations in transitioning from volume- to value-based payment.

Summarizes different approaches and criteria that can be used to identify patients with complex needs for health system interventions.

Contains strategies, tips, and case studies to assist health care stakeholders in building meaningful, person-centered engagement in their organizations.

Describes the needs of distinct subpopulations within the dually eligible population with highly complex needs, along with opportunities for tailored interventions that may reduce health care spending.

Describes core competencies that convey the essential knowledge, skills, and attitudes of complex care practitioners and teams to improve care for people with complex needs.

Analysis of expanded supplemental benefit adoption for Medicare Advantage enrollees

Applying principles of trauma-informed care for patients at end of life.

Medicare patients with the top five percent in preventable utilization account for almost half of all avoidable Medicare costs.

Practical strategies for health plans and ACOs to improve care for patients with serious illness.

Demonstrating return-on-investment to advance effective business relationships between community-based organizations and health care partners.

How can a community-based organization demonstrate the two-way financial benefits of partnering with a health plan?

Hospital system call line expands access to palliative care supports amid COVID-19.

Effective complex care measures vary widely and need to be standardized to better align the field of complex care.

The proportion of low-income, frail, and medically complex individuals enrolled in Medicare Advantage is increasing.

Among high-cost Medicare enrollees, those who are seriously ill, frail, and/or had a serious mental illness experience the most potentially preventable spending.

Accountable care organizations must address key funding, community partnership, and data sharing requirements to successfully integrate social services into medical care.

Providing virtual case mentoring to outpatient care teams may reduce unnecessary hospital and emergency department visits for high-need, high-cost patients.