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
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Identifying Patients with Persistent Preventable Utilization Offers an Opportunity to Reduce Unnecessary Spending
Medicare patients with the top five percent in preventable utilization account for almost half of all avoidable Medicare costs.
Peer-Reviewed Article
Implementing Best Practices in Dementia Care
Clinical tools, training resources, and case studies of evidence-based care models that support people living with dementia and their caregivers.
Implementation Tool
Upstream With a Small Paddle: How ACOs Are Working Against the Current to Meet Patients’ Social Needs
Accountable care organizations must address key funding, community partnership, and data sharing requirements to successfully integrate social services into medical care.
Peer-Reviewed Article
Homage: Calculating the ROI of a Partnership to Meet the Health-Related Social Needs of Medicare Advantage Plan Members
How can a community-based organization demonstrate the two-way financial benefits of partnering with a health plan?
Case Example
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
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
ACO Serious Illness Care: Survey and Case Studies Depict Current Challenges and Future Opportunities
How ACOs are addressing serious illness.
Peer-Reviewed Article
Identifying and Designing the Right Care Management Program: Insights from ACOs
Four care management models for ACOs.
Implementation Tool
The Guide to Integrating Palliative Care into Population Management
Practical strategies for health plans and ACOs to improve care for patients with serious illness.
Implementation Tool
Quick Reference Guide to Promising Care Models
This resource is an updated quick reference guide to promising models for people with complex needs.
Brief/Report
How Accountable Care Organizations Use Population Segmentation to Care for High-Need, High-Cost Patients
Accountable Care Organization leaders explore approaches to segmenting high-need, high-cost populations.
Brief/Report
How ACOs Are Caring for People with Complex Needs
An analysis of the National Survey of ACOs
Brief/Report
The ROI Calculator for Partnerships to Address the Social Determinants of Health
A web-based financial tool that helps navigate partnerships between health care organizations and social service organizations.
Implementation Tool
Complex Care Models to Achieve Accountable Care Readiness: Lessons from Two Community Hospitals
Case studies of two community hospitals show how to advance accountable care.
Case Example
The CHRONIC Care Act of 2018: Advancing Care for Adults with Complex Needs
A brief summarizes what you need to know about the new Chronic Care Act.
Brief/Report
Accountable Care Atlas: A Development Guide for Competency Implementation
This resources describes the competencies organizations need to transition to value-based payment.
Implementation Tool
Toward a Serious Illness Program Design and Implementation Framework
This framework can help you design programs for patients with serious illnesses.
Peer-Reviewed Article
Effective Care for High-Need Patients: Opportunities for Improving Value, Outcomes and Health
The National Academy of Medicine offers a synthesis of the evidence for improving care for high-needs patients.
Brief/Report