Tracking Progress on Person-Centered Care for Older Adults: How Are We Doing?

Reveals inequities in how aging adults’ care preferences are taken into account based on race/ethnicity, income, health insurance status, and other variables.

Brief/Report

January 2021

Money Moves the Mare: The Response of Community‐Based Organizations to Health Care’s Embrace of Social Determinants

Suggests that community-based organizations are responding to Medicaid redesign efforts that prioritize social determinants of health by adopting practices similar to health care organizations.

Peer-Reviewed Article

January 2021

Accountable Care Organization Care Transformation Toolkit

Provides practical steps for current or potential future Medicare accountable care organizations to transform the delivery of care.

Implementation Tool

January 2021

Operational Guide to Identify, Understand, and Treat High-Need Patients

Offers a practical framework for safety-net health systems to better identify and segment patients with complex needs, and tailor care models to meet their needs.

Implementation Tool

September 2020

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

Medicare Advantage Supplemental Benefit Flexibilities: An Early Assessment of Adoption and Policy Opportunities for Expanded Access

Examines the early implementation of Medicare Advantage expanded supplemental benefits, along with policy considerations to promote plan adoption and beneficiary access to these benefits.

Brief/Report

January 2021

Supporting Family Caregivers Providing Complex Care

Includes promising practices, recommendations, vignettes, and other helpful tools to assist health systems in supporting family caregivers providing complex care.

Implementation Tool

November 2020

Lessons Learned from the Transition from Volume to Value

Describes factors that support health care organizations in transitioning from volume- to value-based payment.

Peer-Reviewed Article

October 2020

Person-Centered Engagement at the Organizational Level

Contains strategies, tips, and case studies to assist health care stakeholders in building meaningful, person-centered engagement in their organizations.

Implementation Tool

January 2020

Identifying Populations with Complex Needs: Variation in Approaches Used to Select Complex Patient Populations

Summarizes different approaches and criteria that can be used to identify patients with complex needs for health system interventions.

Peer-Reviewed Article

September 2020

Aligning Social and Health Care Services: The Case of Community Care Connections

Demonstrates that a program assisting older adults with complex needs in navigating medical and social services may lower acute care utilization.

Peer-Reviewed Article

November 2020

Medicare-Medicaid Integration: A Reference Guide to Emerging Evidence and Technical Assistance Tools

This reference guide summarizes a set of curated resources to help key stakeholders better understand both the needs of the dually eligible population and emerging evidence and practical approaches for advancing Medicare-Medicaid integration.

Implementation Tool

January 2021

Effects of Integrating Care for Medicare-Medicaid Dually Eligible Seniors in Minnesota

Examines the potential for Minnesota’s integrated care model to lower use of hospital care and increase use of primary care and community-based services for dually eligible older adults.

Peer-Reviewed Article

July 2018

Integrated Care Programs for Dually Eligible Individuals in the Era of COVID-19: Response Efforts and Policy Recommendations

Identifies opportunities to strengthen integrated programs to improve care and support positive health outcomes for dually eligible individuals both during and beyond the pandemic.

Brief/Report

September 2020

Comparing Care for Dual-Eligibles across Coverage Models: Empirical Evidence from Oregon

Explores different characteristics of dually eligible individuals that have different coverage types, as well as the impact of aligned Medicare and Medicaid benefits to improve quality of care and utilization outcomes.

Peer-Reviewed Article

November 2017

Starting from Square One: Considerations for States Exploring Medicare-Medicaid Integration

Poses key questions to help states new to Medicare-Medicaid integration assess readiness for integration and select an achievable integration approach.

Brief/Report

May 2020

State Pathways to Integrated Care: Exploring Options for Medicare-Medicaid Integration

Outlines steps states can take to advance Medicare-Medicaid integration depending on policy goals, internal capacity, and delivery system structures.

Implementation Tool

April 2019

The Role of Social, Cognitive, and Functional Risk Factors in Medicare Spending for Dual and Nondual Enrollees

Details how dually enrolled beneficiaries have significantly higher levels of comorbidities and higher costs of care than their non-dually enrolled counterparts.

Peer-Reviewed Article

April 2019

Meal Delivery Programs Reduce the Use of Costly Health Care in Dually Eligible Medicare and Medicaid Beneficiaries

Examines how home meal delivery programs show promise for reducing the use of costly health care and decreasing spending for dually eligible individuals.

Peer-Reviewed Article

April 2018

The Value of Pursuing Medicare-Medicaid Integration for Medicaid Agencies

Highlights early findings demonstrating that Medicare-Medicaid integration can improve beneficiary experience and health outcomes, increase program efficiencies, and improve Medicaid program management.

Brief/Report

November 2019

All Resources

All Resources

Topics

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Content Types

Tracking Progress on Person-Centered Care for Older Adults: How Are We Doing?

Money Moves the Mare: The Response of Community‐Based Organizations to Health Care’s Embrace of Social Determinants

Accountable Care Organization Care Transformation Toolkit

Operational Guide to Identify, Understand, and Treat High-Need Patients

Medical Care at Home Comes of Age

Medicare Advantage Supplemental Benefit Flexibilities: An Early Assessment of Adoption and Policy Opportunities for Expanded Access

Supporting Family Caregivers Providing Complex Care

Lessons Learned from the Transition from Volume to Value

Person-Centered Engagement at the Organizational Level

Identifying Populations with Complex Needs: Variation in Approaches Used to Select Complex Patient Populations

Aligning Social and Health Care Services: The Case of Community Care Connections

Medicare-Medicaid Integration: A Reference Guide to Emerging Evidence and Technical Assistance Tools

Effects of Integrating Care for Medicare-Medicaid Dually Eligible Seniors in Minnesota

Integrated Care Programs for Dually Eligible Individuals in the Era of COVID-19: Response Efforts and Policy Recommendations

Comparing Care for Dual-Eligibles across Coverage Models: Empirical Evidence from Oregon

Starting from Square One: Considerations for States Exploring Medicare-Medicaid Integration

State Pathways to Integrated Care: Exploring Options for Medicare-Medicaid Integration

The Role of Social, Cognitive, and Functional Risk Factors in Medicare Spending for Dual and Nondual Enrollees

Meal Delivery Programs Reduce the Use of Costly Health Care in Dually Eligible Medicare and Medicaid Beneficiaries

The Value of Pursuing Medicare-Medicaid Integration for Medicaid Agencies