Evidence-based intervention at a behavioral health home improved health outcomes for patients with co-occurring type 2 diabetes and serious mental illness.
Medicare Advantage plans report different barriers to partnering with community-based organizations, but there are strategies to develop effective partnerships.
Personalized patient navigation supports for people with comorbid substance use disorders reduced rates of hospital readmissions and emergency department use.
Over 14 years, individuals experiencing chronic homelessness enrolled in a permanent supportive housing program had low housing retention and high mortality.
A permanent supportive housing program reduced emergency department visits within the first six months of placement but showed neutral effects on total cost of care and primary care utilization for Medicaid enrollees.
Primary care and alternative payment models that reduce emergency department use and increase access to care for high-need populations share core components for success.
Disparities in transitional care training for caregivers of older adults based on race or financial status demonstrate need for changes in discharge processes and strategies to address bias.
Home-based program provided by a community health and social worker reduces acute care use and improves care for older adults with complex health and social needs.
Implementing a predictive model in acute settings can more reliably identify patients with high mortality risk, which can assist providers in prioritizing advance care planning.
Use of machine learning clustering algorithms revealed 30 distinct subgroups of patients among high-risk veterans, indicating a need for tailored approaches to health care.
The 4Ms approach developed for the Age-Friendly Health System model — what matters, medication, mentation, mobility — has a robust evidence base for providing quality care to older adults.
Medication management interventions that support caregivers of people with dementia at care transitions can help reduce readmissions, caregiver burden, and use of high-risk medication.
Many physicians report low confidence in caring for patients with disability and negative perceptions about quality of life with a disability, which may reflect biased views that potentially contribute to persistent health disparities.