A Comprehensive Medication Management program that employs a remote clinical pharmacist effectively addresses most drug therapy problems in a complex care population.

A novel street psychiatry program offers essential mental health support to unsheltered individuals experiencing homelessness.

During the COVID-19 pandemic, Cityblock Health implemented a virtually integrated care management model to maintain continuity of care for patients with complex needs.

A pharmacist-led substance use disorder intervention improved treatment retention for patients with opioid and alcohol use disorder.

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.

Literature review examines the roles and contributions of community health workers in improving dementia care.

An integrated community health program demonstrated a cost savings of over three million dollars.

Community health worker-led interventions for older adults with complex needs show evidence of improving participant mood and functional outcomes.

Initiative successfully implemented several evidence-based and promising addiction care models across multiple medical settings, including an inpatient addiction consult team, a low-threshold bridge clinic, peer recovery coaches, and office-based addiction treatment nurses.

Demonstrates that a program assisting older adults with complex needs in navigating medical and social services may lower acute care utilization.

Describes core competencies that convey the essential knowledge, skills, and attitudes of complex care practitioners and teams to improve care for people with complex needs.

Demonstrates that intensive outpatient care programs show promise in reducing utilization and costs and improving patient outcomes for high-need, high-cost populations.

Applying principles of trauma-informed care for patients at end of life.

Explored opportunities for health systems and plans to work with CHW/Ps to support high-need individuals, with a focus on addressing the long-term impacts of the COVID-19 pandemic.

Using community health workers can reduce hospitalizations in high-risk patients.

CHW intervention reduced health care costs and utilization for low-income women with depression.

Toolkit offers health care stakeholders in rural areas with practical information to support the design, implementation, and evaluation of community paramedicine programs.

This toolkit shares business strategies, sample protocols, and best practice clinical tools for health care providers interested in developing a home-based palliative care program.

Community health worker programs can offset program costs through reduced utilization.

Social workers on rural primary care teams may help decrease high-risk veterans’ acute care use.