Displaying 1 - 19 of 19

Care Ecosystem Collaborative Model and Health Care Costs in Medicare Beneficiaries with Dementia

Randomized controlled trial shows that a collaborative dementia care model leads to reduction in costs among a sample of Medicare patients.

Peer-Reviewed Article

September 2023

Addressing Healthcare Utilization and Costs for Older Adults with Limited Mobility Through a Multidisciplinary Home-Based Primary Care Program

An interdisciplinary home-based primary care program for older adults with limited mobility leads to reductions in health care utilization and costs.

Peer-Reviewed Article

August 2023

The Association Between Primary Care Practices’ Structural Capabilities and Hospitalizations Among Persons Living with Dementia

Care coordination services in primary care clinics are shown to reduce avoidable hospitalizations among persons living with dementia.

Peer-Reviewed Article

July 2023

Scaling Primary Care Social Needs Screening and Referrals in New York City’s Safety-Net Health System

An overview of NYC Health + Hospital’s implementation of a primary care-based social needs screening and referral program, including key implementation challenges and success factors.

Case Example

June 2023

Community Health Worker Programs

Curates recent evidence behind community health worker programs that support people with complex health and social needs, as well as practical strategies to support effective implementation of these programs.

Collection

April 2023

Complex Community Health and Social Care Interventions – Which Features Lead to Reductions in Hospitalizations for Ambulatory Care Sensitive Conditions? A Systematic Literature Review

Primary care-based interventions that integrate community health and social care services can reduce the rate of avoidable hospitalizations.

Peer-Reviewed Article

December 2022

Integrating Spiritual Care in Population Health and Care Management: Two Case Examples

Including spiritual care within care management programs in outpatient, managed care, and population health settings can enhance patient care and support the effectiveness of the interdisciplinary care team.

Case Example

September 2022

Impacts of Community-Based Care Program on Health Care Utilization and Cost

Community-based care management programs for patients with complex health and social needs have the potential to reduce hospitalizations and inpatient costs.

Peer-Reviewed Article

April 2022

Frontline Provider Perceptions of Implementing Home-Based Palliative Care Covered by an Insurer

Home-based palliative care providers explore key facilitators and barriers to effectively delivering care within a value-based payment environment.

Peer-Reviewed Article

November 2021

From the Hospital to the Streets: Bringing Care to the Unsheltered Homeless in Los Angeles

A street medicine program increased post-hospitalization follow-up care for unsheltered individuals experiencing homelessness in Los Angeles.

Case Example

September 2021

Designing a Home-Based Palliative Care Program

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.

Implementation Tool

June 2020

A Novel Intervention for High-Need, High-Cost Patients: A Study of ECHO Care

Providing virtual case mentoring to outpatient care teams may reduce unnecessary hospital and emergency department visits for high-need, high-cost patients.

Peer-Reviewed Article

January 2020

ECHO Care: Providing Multidisciplinary Specialty Expertise to Support the Care of Complex Patients

Connecting complex care teams with specialists through videoconferencing can increase their effectiveness in caring for high-need high-cost patients.

Peer-Reviewed Article

January 2020

Effects of a Population Health Community-Based Palliative Care Program on Cost and Utilization

A community-based palliative care program reduced medical costs, intensive care unit (ICU) admissions, hospital admissions, and days spent in the hospital for Medicare Advantage members with serious illness.

Peer-Reviewed Article

September 2019

Serious Illness Approaches by ACOs: Facey Medical Group

This case study analyzes a successful example of a medical group partnering with a home health agency to provide community-based palliative care for high-risk members of their accountable care organization.

Case Example

May 2019

The Impact of a Community-Based Serious Illness Care Program on Healthcare Utilization and Patient Care Experience

Care model that integrates home-based primary care and palliative care for patients with serious illness reports reduced health care utilization and improved patient care experience.

Peer-Reviewed Article

February 2019

Diffusion of Community Health Workers Within Medicaid Managed Care: A Strategy to Address Social Determinants of Health

New Mexico’s model to deploy community health workers is now replicated in 12 states.

Case Example

July 2017

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

March 2017

Effect of a Home-Based Palliative Care Program on Healthcare Use and Costs

A home-based palliative care program using an interdisciplinary care team reduces hospital costs and unnecessary health care utilization for Medicare Advantage beneficiaries.

Peer-Reviewed Article

November 2016

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Care Ecosystem Collaborative Model and Health Care Costs in Medicare Beneficiaries with Dementia

Addressing Healthcare Utilization and Costs for Older Adults with Limited Mobility Through a Multidisciplinary Home-Based Primary Care Program

The Association Between Primary Care Practices’ Structural Capabilities and Hospitalizations Among Persons Living with Dementia

Scaling Primary Care Social Needs Screening and Referrals in New York City’s Safety-Net Health System

Community Health Worker Programs

Complex Community Health and Social Care Interventions – Which Features Lead to Reductions in Hospitalizations for Ambulatory Care Sensitive Conditions? A Systematic Literature Review

Integrating Spiritual Care in Population Health and Care Management: Two Case Examples

Impacts of Community-Based Care Program on Health Care Utilization and Cost

Frontline Provider Perceptions of Implementing Home-Based Palliative Care Covered by an Insurer

From the Hospital to the Streets: Bringing Care to the Unsheltered Homeless in Los Angeles

Designing a Home-Based Palliative Care Program

A Novel Intervention for High-Need, High-Cost Patients: A Study of ECHO Care

ECHO Care: Providing Multidisciplinary Specialty Expertise to Support the Care of Complex Patients

Effects of a Population Health Community-Based Palliative Care Program on Cost and Utilization

Serious Illness Approaches by ACOs: Facey Medical Group

The Impact of a Community-Based Serious Illness Care Program on Healthcare Utilization and Patient Care Experience

Diffusion of Community Health Workers Within Medicaid Managed Care: A Strategy to Address Social Determinants of Health

Innovative Home Visit Models Associated with Reductions in Costs, Hospitalizations, and Emergency Department Use

Effect of a Home-Based Palliative Care Program on Healthcare Use and Costs