Resources

Community health workers (CHWs) connect underserved individuals to health and social services, offering the potential to help reduce health care costs associated with mental health issues by...
IMPaCT is a standardized community health worker (CHW) intervention for high-risk patients that has been previously evaluated in three randomized clinical trials across various clinical settings and...
While community health worker (CHW) programs that serve low-income populations have demonstrated reductions in preventable acute care utilization, these programs often have limited funding. Developing...
Adults with serious mental illness (SMI) are at much greater risk than the general population for cardiovascular disease, and require tailored interventions to address co-occurring cardiovascular risk...
Low-income individuals with diabetes who experience unstable housing and food insecurity are likely to have increased emergency department (ED) visits and hospitalizations. This study evaluated the...
Individuals with serious mental illness (SMI) have high preventable emergency department (ED) usage, often due to poorly managed chronic medical conditions. A North Carolina primary care center...
The coronavirus pandemic intensified the already pressing need for the communication and symptom management expertise of palliative care specialists. Amid the surge of COVID-19 cases in New York City...
Accountable care organizations (ACOs) have shown promise in improving care for individuals with chronic conditions who also have coexisting mental health conditions, in part by incentivizing hospitals...
Cityblock Health provides care to populations with high rates of social, behavioral, and health risk factors, many of whom are at higher risk for complications from COVID-19. Cityblock developed a...
Medicaid health homes were created by the Affordable Care Act to improve care for Medicaid enrollees with complex behavioral and physical health needs. Health homes that target behavioral health...
Complex care programs across the country use varied criteria to identify people with complex health and social needs and measure the effectiveness of subsequent interventions. Greater standardization...
Although health care systems commonly refer individuals with unmet social needs to social service agencies, in some cases, these agencies may not have the capacity to provide adequate assistance. This...