Care management programs should include processes for evaluating patient-reported outcomes.

Health Resilience Specialists work with the patients to meet their personal health needs

The U.S. had the highest rate of cost-related access problems.

There are many promising strategies to segment individuals with complex needs. Here is one conceptual framework.

Much of the evidence comes from small studies, so further testing is needed.

Key opportunities include strengthening information technology connections across service providers.

Segmenting the high-cost population is the first step in matching appropriate care management strategies.

This report presents the findings from the evaluation of Medicaid health homes, created as part of the Affordable Care Act.

Emergency department-initiated buprenorphine for opioid-dependent patients demonstrated significantly higher rates of addiction treatment engagement than interventions without buprenorphine.

Incorporating community engagement into public health interventions leads to improved health outcomes and a greater sense of self-efficacy among intervention recipients.

The approach identifies patients through chart review and data analytics coupled with the intelligence of community health workers.

Systematic review finds that medical respite programs reduce acute care utilization outcomes for people experiencing homelessness.