Resources

Making Lemonade from a Very Sour Lemon: Capitalizing on Regulatory Flexibilities Born from the COVID-19 Public Health Emergency
This blog post highlights opportunities for long-term care providers to leverage federal and state flexibilities to adopt new ways of delivering services to older adults and people with complex needs, as well as addressing barriers to care created by the COVID-19 pandemic.
How Community Health Workers and Promotores Can Support Individuals with Complex Needs amid COVID-19
Community health workers and promotores (CHW/Ps), who typically live in the neighborhoods they serve, are uniquely positioned to foster trusting relationships and help individuals navigate the health...
Health Care Access Now: Calculating the ROI of a Care Coordination Program to Address Social Determinants of Health
The Return-on-Investment (ROI) Calculator for Partnerships to Address the Social Determinants of Health, developed by The Commonwealth Fund, is designed to support successful financial partnerships...
Homage: Calculating the ROI of a Partnership to Meet the Health-Related Social Needs of Medicare Advantage Plan Members
The Return-on-Investment (ROI) Calculator for Partnerships to Address the Social Determinants of Health, developed by The Commonwealth Fund, is designed to help support successful financial...
How a Nonprofit Organization Gets Paid to Address Social Needs
This blog post highlights how this ROI calculator can help community-based organizations and health system partners integrate nonmedical services in a financially sustainable way.
Effect of a Comprehensive Cardiovascular Risk Reduction Intervention in Persons With Serious Mental Illness: A Randomized Clinical Trial
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...
Evaluation of a National Care Coordination Program to Reduce Utilization Among High-Cost, High-Need Medicaid Beneficiaries with Diabetes
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...
Improving Care for High-Need, High-Cost Patients: The View from a Community Health Worker and a Social Worker
In this blog post, a community health worker and social worker from CareMore Health share their perspective on the importance of their roles in lowering costs and improving outcomes for high-need patients.
The Effects of an Enhanced Primary Care Model for Patients with Serious Mental Illness on Emergency Department Utilization
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...
Caring for Older Adults with Complex Needs in the COVID-19 Pandemic: Lessons from PACE Innovations
The Program of All-Inclusive Care for the Elderly (PACE) is an evidence-based model of care for older adults who meet a nursing-home level of care, but live in community settings. Across the country...
Adapting Medications for Addiction Treatment Programs in Response to COVID-19
This blog post highlights opportunities for providers to implement medications for addiction treatment programs during COVID-19.
Medications for Addiction Treatment: Providing Best Practice Care in a Primary Care Clinic
Medications for addiction treatment (MAT) programs implemented in primary care settings need to go beyond prescribing and dispensing medication to fully address the complex health and social needs of...

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Addressing Complex Care Needs Amid COVID-19

Resource Center: Addressing Complex Care Needs Amid COVID-19