A comprehensive overview of different funding approaches to sustainably finance CHW programs.

Community health worker-led program associated with reduced acute care utilization and lower Medicaid and total costs for dually eligible individuals.

A health-plan-administered telehealth care coaching intervention led to long-term cost savings as well as increased behavioral health service use for adults with behavioral health needs and a history of high utilization.

A health plan-led telepsychiatry program for older adults can address the shortage of psychiatrists to improve outcomes related to depression and access to mental health care.

Including spiritual care within care management programs in outpatient, managed care, and population health settings can enhance patient care and support the effectiveness of the interdisciplinary care team.

Study details permanent supportive housing program implementation and how this impacts outcomes and costs.

Simulation model estimates that national implementation of medically tailored meal programs for specific populations would achieve over $13.6 billion in cost savings per year.

Highlighted two community paramedicine programs in New England and rural North Carolina that serve people with complex needs.

This description and application of a valid and reliable measure of equity of inpatient hospital experiences can help hospitals collect better data to meaningfully promote high-quality equitable care.

One health plan’s approach to addressing racial and ethnic disparities in medication adherence rates offers insights on levers to address racial inequities.

Details how two health plans in California developed programs to transition dually eligible members from institutional settings back into their communities.

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.

Health insurers can implement strategies to address bias in machine learning and predictive modeling used in care management to help reduce health inequities and racial disparities.

Describes the core elements and evidence base behind a home- and community-based palliative care model that was designed by stakeholders to support the health needs of people with serious illness.

This guide describes key strategies for health plans, accountable care organizations, and health systems to improve care for people with serious illness.

A health-related quality of life measure can be a leading indicator for future adverse health outcomes for older adults.

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

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

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.

Segmentation framework with publicly available code files identifies specific and actionable patient cohorts with complex needs.