Case Management and Home Assessments Reduce Asthma-Related Admissions, Emergency Visits, and Missed School Days in Diverse Urban Children
Case management combined with in-home environmental assessment and remediation of environmental triggers reduce asthma-related hospitalizations, emergency department visits, missed school days, and missed parent work days in diverse, low-income urban children with asthma.
Managed Care Organization and Visiting Nurse Association Offer Standardized Education to Elderly Heart Failure Patients, Improving Self-Management and Reducing Readmissions
Kaiser Permanente Colorado and the Visiting Nurse Association in Denver jointly offer intense, consistent education to elderly heart failure patients discharged from the hospital in need of home-based skilled nursing care, leading to improved knowledge and self-management skills and fewer readmissions.
Locating Mental and Behavioral Health Services in Health Plan Centers Enhances Access and Reduces Utilization of Inpatient Psychiatric Services for Community-Dwelling Frail Seniors
A mental and behavioral health team periodically works onsite at health plan centers to facilitate patient access to mental health services, reducing psychiatric inpatient utilization and generating high levels of staff satisfaction.
Medical Outreach to HIV Patients in Unstable Housing Increases Use of Care and HIV-Related Medications and Improves Patient Perceptions of Quality
The Medical Outreach Program enhanced services provided to unstably housed, minority individuals with human immunodeficiency virus by including physicians on the community outreach team who provide general medical consultation, triage, acute care, evaluation, and prescriptions for needed medications.
Public Health Nurses Provide Case Management to Low-Income Women With Chronic Conditions, Leading to Improved Mental Health and Functional Status
Public health nurses provide case management services to women with one or more chronic conditions who receive Temporary Assistance for Needy Families, leading to enhanced access to mental health services, fewer depressive symptoms, and improved functional status.
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Risk Management and Quality in Home- and Community-Based Services (HCBS): Individual Risk Planning and Prevention, System-wide Quality Improvement
This report explores the topic of effective individual risk management in community-based services among States engaged in risk planning for Medicaid home- and community-based services (HCBS) waiver participants.
Improving the Quality of Home and Community Based Services and Supports, Work Book
This workbook helps States improve the quality of home- and community-based programs and supports (HCBS) programs. It will help users understand, design, implement, document, and monitor the components of a quality improvement process for HCBS programs.
Participant Experience Survey (Brain Injury)
This survey solicits feedback from program participants with brain injury about the services and supports they receive under the Medicaid Home and Community-Based Services waiver program.
Participant Experience Survey: Elderly/Disabled (E/D) Version
This survey solicits feedback from elderly and disabled program participants about the services and supports they receive under the Medicaid Home and Community-Based Services waiver program.
STate Action on Avoidable Rehospitalizations (STAAR) Materials
The STate Action on Avoidable Rehospitalizations (STAAR) Initiative of the Institute for Healthcare Improvement and The Commonwealth Fund aims to reduce avoidable rehospitalizations. This Web site features guides, presentations, and other tools related to reducing readmissions.