Medical Care at Home Comes of Age Provides an overview of home-based medical care models, the patients that they serve, and their robust evidence base. Brief/Report January 2021
Age-Friendly Health Systems: Guide to Using the 4Ms in the Care of Older Adults Step-by-step guide with robust tools for health systems to apply the 4Ms framework to deliver age-friendly, evidence-based care for older adults. Implementation Tool July 2020
Health Care Hotspotting — A Randomized, Controlled Trial Randomized controlled trial of a care management intervention offers important lessons for the field of complex care. Peer-Reviewed Article January 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
AAHCM Toolkit: Building Awareness and Engaging Payers to Bring Home-Based Primary Care into the Mainstream The benefits of home-based primary care. Implementation Tool June 2019
Impact of Primary Care Intensive Management on High-Risk Veterans’ Costs and Utilization Supplementing primary care with team-based management. Peer-Reviewed Article June 2019
Impact of a Complex Chronic Care Patient Case Conference on Quality and Utilization The case conference approach to caring for complex patients. Peer-Reviewed Article May 2018
Case Management in Primary Care for Frequent Users of Health Care Services: A Mixed Methods Study The psychological benefits of case management. Peer-Reviewed Article May 2018
Disruptive Models in Primary Care: Caring for High-Needs, High-Cost Populations Promising approaches to managing care illustrated through a clinical vignette. Case Example April 2017
The Health Resilience Program: A Program Assessment Health Resilience Specialists work with the patients to meet their personal health needs Case Example January 2016