This resource describes how HBPC practices assess the non-medical social needs of older adults who are homebound and identifies barriers to coordinating home and commu
This resource describes a study of the Johns Hopkins Community Health Partnership (J-CHiP), which was created as a regional approach to health care transformation in Baltimo
This resource describes a study assessing the effects of patient activation and engagement strategies on patient-reported outcomes for patients with diabetes and/or cardiovascular
This resource describes a study of how health care providers and social services providers coordinate their work in communities that achieve relatively low health care utili
This resource describes a randomized quality improvement trial that assessed whether augmenting usual primary care with team-based intensive management lowers utilization and cost
This resource reviews the literature on case management programs published over the past 17 years, arguing that application of two theories (agency and street-level bureaucratic t
This resource analyzes the drivers of cost for Medicare-Medicaid beneficiaries, particularly looking at the differences between persistent and transient high costs.
This resource reviews efforts of academic medical centers (AMCs) to improve care for patients with complex needs, and the opportunities for AMCs to contribute to better care throu
This resource describes the evolution of complex care management targeting strategies in Community Care of North Carolina’s (CCNC) work with the statewide non-dual Medicaid popula
This resource assesses HealthChoices HealthConnections, an integration pilot program for Medicaid beneficiaries with SMI and co-occurring chronic conditions in t
