By closing gaps in care, a safety-net ACO has reduced medical costs for Medicaid patients with complex needs.

Experts describe how delivery systems can effectively serve adults with complex needs.

Dual-eligible beneficiaries are often more sick, have greater functional and cognitive impairments, and require more care coordination.

Improving care for high-need, high-cost patients is a key lever to decrease national health spending.

“Clubhouses” for people with serious mental illness are effective at promoting employment, reducing hospitalizations, and improving quality of life.

Interdisciplinary teams provide support for Medicaid beneficiaries with mental illnesses, addictions, and other needs.

This literature review assesses the impact of social service interventions.

Provider incentives must be based on Triple Aim outcomes.

Successful long-term services and supports programs have a single point of accountability, such as a care manager.

A standardized tool to assess where along a continuum a program lies with regard to components of integration.

A study of five programs identified key factors that support collaboration among community-based health and social services.

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.

Key opportunities include strengthening information technology connections across service providers.

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.

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