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
All Resources
All Resources
Topics
Populations
Audiences
Content Types
A Systematic Review of Intensive Outpatient Care Programs for High-Need, High-Cost Patients
Demonstrates that intensive outpatient care programs show promise in reducing utilization and costs and improving patient outcomes for high-need, high-cost populations.
Peer-Reviewed Article
Use of General Primary Care, Specialized Primary Care, and Other Veterans Affairs Services Among High-Risk Veterans
Integrated health care systems can better support high-risk patients by embedding high-risk patient care within general primary care and mental health care.
Peer-Reviewed Article
The Effects of an Enhanced Primary Care Model for Patients with Serious Mental Illness on Emergency Department Utilization
Enhanced primary care for Medicaid enrollees with serious mental illness can help decrease emergency department use over time.
Peer-Reviewed Article
Embedding Social Workers In Veterans Health Administration Primary Care Teams Reduces Emergency Department Visits
Social workers on rural primary care teams may help decrease high-risk veterans’ acute care use.
Peer-Reviewed Article
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
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
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
Fostering Resilience and Recovery: A Change Package for Advancing Trauma-Informed Primary Care
Implementing a trauma-informed approach in primary care.
Implementation Tool
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
Impact of Primary Care Intensive Management on High-Risk Veterans’ Costs and Utilization
Supplementing primary care with team-based management.
Peer-Reviewed Article
Outcomes of a Citywide Campaign to Reduce Medicaid Hospital Readmissions with Connection to Primary Care Within 7 Days of Hospital Discharge
The importance of timely primary care follow-up.
Peer-Reviewed Article
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
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
Disruptive Models in Primary Care: Caring for High-Needs, High-Cost Populations
Promising approaches to managing care illustrated through a clinical vignette.
Case Example
New Models of Primary Care Workforce and Financing: Case Example #1: Stanford Coordinated Care
Stanford Coordinated Care provides university employees with complex health needs better care at a lower cost
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
Project ECHO’s Complex Care Initiative: Building Capacity to Help “Superutilizers”
Interdisciplinary teams provide support for Medicaid beneficiaries with mental illnesses, addictions, and other needs.
Case Example
The Health Resilience Program: A Program Assessment
Health Resilience Specialists work with the patients to meet their personal health needs
Case Example