Disruptive Models in Primary Care: Caring for High-Needs, High-Cost Populations
Promising approaches to managing care illustrated through a clinical vignette.
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Care Management Plus: Strengthening Primary Care for Patients with Multiple Chronic Conditions
A program to help clinics deliver comprehensive care may decrease mortality and hospitalization rates.
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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
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Guided Care: A Structured Approach to Providing Comprehensive Primary Care for Complex Patients
Guided Care is designed to strike a balance between telephone-based and interdisciplinary team-based care management programs.
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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.
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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.
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Aging Gracefully: The PACE Approach to Caring for Frail Elders in the Community
Reviews lessons from the Program of All-Inclusive Care for the Elderly on serving high-need populations in community settings.
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Bringing Primary Care Home: The Medical House Call Program at MedStar Washington Hospital Center
Providing the frail elderly with 24/7 access to an interdisciplinary care team reduced expected spending by 20 percent.
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The Health Resilience Program: A Program Assessment
Health Resilience Specialists work with the patients to meet their personal health needs
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