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
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Effect of a Comprehensive Cardiovascular Risk Reduction Intervention in Persons With Serious Mental Illness: A Randomized Clinical Trial
A randomized clinical trial of an 18-month comprehensive intervention showed significant reductions in cardiovascular disease risk in adults with serious mental illness.
Peer-Reviewed Article
Integrating Health And Human Services In California’s Whole Person Care Medicaid 1115 Waiver Demonstration
California’s Whole Person Care pilot can inform cross-sector initiatives to improve care for Medicaid enrollees with complex health and social needs.
Peer-Reviewed Article
What’s Next? The Value of Evidence from the Camden Coalition and CareMore Health to Inform Complex Care Program Design
Highlighted lessons from two recent studies to help guide future program and measurement approaches for complex care management interventions.
Webinar
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
The Common Attributes of Successful Care Manager Programs for High-Need, High-Cost Persons: A Cross-Case Analysis
Ten common attributes for successful care management programs serving high-need, high-cost populations.
Peer-Reviewed Article
‘Eyes in The Home’: ACOs Use Home Visits to Improve Care Management, Identify Needs, And Reduce Hospital Use
How home visits are used by ACOs to improve care, lower costs.
Peer-Reviewed Article
Time and Effort in Care Coordination for Patients with Complex Health and Social Needs: Lessons From a Community-Based Intervention
Staff time effort in complex care coordination programs is highly variable depending on patients’ health and social needs.
Peer-Reviewed Article
Identifying and Designing the Right Care Management Program: Insights from ACOs
Four care management models for ACOs.
Implementation Tool
How ACOs Are Caring for People with Complex Needs
An analysis of the National Survey of ACOs
Brief/Report
Outpatient Complex Case Management: Health System-Tailored Risk Stratification Taxonomy to Identify High-Cost, High-Need Patients
Maximizing the impact of outpatient complex case management.
Peer-Reviewed Article
Going Beyond Clinical Care to Reduce Health Care Spending
A regional approach to health care transformation.
Peer-Reviewed Article
Active Redesign of a Medicaid Care Management Strategy for Greater Return on Investment: Predicting Impactability
This resource describes one tool to identify patients most likely to benefit from care management.
Peer-Reviewed Article
Integrating Health Care for High-Need Medicaid Beneficiaries With Serious Mental Illness and Chronic Physical Health Conditions at Managed Care, Provider, and Consumer Levels
This resource describes the value of navigators for Medicaid beneficiaries with mental illness.
Peer-Reviewed Article
Bending the Spending Curve: The Role of Care Management in a Pioneer ACO
ACOs have lowered costs for high-need patients through care management programs focused on modifiable spending.
Peer-Reviewed Article
Disruptive Models in Primary Care: Caring for High-Needs, High-Cost Populations
Promising approaches to managing care illustrated through a clinical vignette.
Case Example
CareMore: Improving Outcomes and Controlling Health Care Spending for High-Needs Patients
CareMore’s business model identifies high-risk patients and surrounds them with coordinated services
Case Example
The Business Case for Community Paramedicine: Lessons from Commonwealth Care Alliance’s Pilot Program
Cost considerations for the expansion of mobile integrated health care and community paramedicine programs.
Case Example
Hennepin Health: A Care Delivery Paradigm for New Medicaid Beneficiaries
By closing gaps in care, a safety-net ACO has reduced medical costs for Medicaid patients with complex needs.
Case Example