All Resources
Topics
Populations
Audiences
Content Types
State
Topics
Populations
Audiences
Content Types
State
Displaying 81 - 100 of 107
How ACOs Are Caring for People with Complex Needs
An analysis of the National Survey of ACOs
Brief/Report
Outpatient Complex Case Management: Health System-Tailored Risk Stratification Taxonomy to Identify High-Cost, High-Need Patients
Maximizing the impact of outpatient complex case management.
Peer-Reviewed Article
Going Beyond Clinical Care to Reduce Health Care Spending
A regional approach to health care transformation.
Peer-Reviewed Article
Home: Perhaps the Most Important “Care Setting”
The program, known as Community Aging in Place — Advancing Better Living for Elders (CAPABLE), is a client-directed home-based intervention to increase mobility, functionality, and capacity to “age in place” for older adults.
Blog
June 2018
Caring for the Whole Person: Two Patient Stories in Complex Care Management
Effective complex care means first understanding the individual and the challenges they face in their day-to-day lives. Here are two stories of patients in the CareMore Touch program for people with institutional special needs.
Blog
May 2018
Active Redesign of a Medicaid Care Management Strategy for Greater Return on Investment: Predicting Impactability
This resource describes one tool to identify patients most likely to benefit from care management.
Peer-Reviewed Article
Managing Effectively in Complex Chronic Care Markets
This resource provides a road map for health plans to improve Medical Loss Ratio.
Peer-Reviewed Article
Care Ecosystem Toolkit
Details implementation guidance for the evidence-based Care Ecosystem model, which improves supports for people with dementia and their caregivers.
Implementation Tool
Community Health Worker Support for Disadvantaged Patients with Multiple Chronic Diseases: A Randomized Clinical Trial
This resource describes the benefits of community health workers for people with multiple chronic conditions.
Peer-Reviewed Article
Integrating Health Care for High-Need Medicaid Beneficiaries With Serious Mental Illness and Chronic Physical Health Conditions at Managed Care, Provider, and Consumer Levels
This resource describes the value of navigators for Medicaid beneficiaries with mental illness.
Peer-Reviewed Article
Bending the Spending Curve: The Role of Care Management in a Pioneer ACO
ACOs have lowered costs for high-need patients through care management programs focused on modifiable spending.
Peer-Reviewed Article
CareMore: Improving Outcomes and Controlling Health Care Spending for High-Needs Patients
CareMore’s business model identifies high-risk patients and surrounds them with coordinated services
Case Example
Innovative Home Visit Models Associated with Reductions in Costs, Hospitalizations, and Emergency Department Use
Home visits can reach patients with complex needs before a higher level of care is needed
Peer-Reviewed Article
Care Management Plus: Strengthening Primary Care for Patients with Multiple Chronic Conditions
A program to help clinics deliver comprehensive care may decrease mortality and hospitalization rates.
Case Example
The Business Case for Community Paramedicine: Lessons from Commonwealth Care Alliance’s Pilot Program
Cost considerations for the expansion of mobile integrated health care and community paramedicine programs.
Case Example
Intensive Outpatient Care Program Toolkit
The staff position of care coordinator is crucial to success.
Implementation Tool
Hennepin Health: A Care Delivery Paradigm for New Medicaid Beneficiaries
By closing gaps in care, a safety-net ACO has reduced medical costs for Medicaid patients with complex needs.
Case Example
Guided Care: A Structured Approach to Providing Comprehensive Primary Care for Complex Patients
Guided Care is designed to strike a balance between telephone-based and interdisciplinary team-based care management programs.
Case Example
Home-Based Care Program Reduces Disability and Promotes Aging in Place
Difficulty with activities of daily living is a major cost driver in health care that is typically overlooked.
Peer-Reviewed Article