Automated Clinician Prompts and Referrals Facilitate Access to Counseling Services, Leading to Positive Behavior Changes Among Patients
Automated clinician prompts and referrals facilitates access to behavior counseling, leading to improved behaviors related to diet and exercise and higher quit rates among smokers.
Care Coordinators Support Individuals With Severe Mental Illness, Leading to Improved Quality of Life and Lower Costs
The seven-county New York Care Coordination Program offers comprehensive care coordination for individuals with severe mental illness through assessment, individualized goal setting, and access to social programs, leading to improved quality of life and coping skills, fewer emergency department visits and inpatient days, and lower costs.
Clinical Pharmacists Provide Outpatient Medication Management to Patients With Severe Diabetes and Those on Anticoagulants, Leading to Improved Outcomes and Lower Costs
Clinical pharmacists working in 13 community health centers provide medication reconciliation, monitoring, dosage adjustments, and education to high-risk patients, including those with severe diabetes and those on anticoagulants.
Community Coalition Connects Medical Practices to Community Resources, Leading to Improved Asthma and Diabetes Outcomes in At-Risk Populations
King County Steps to Health connected medical practices to community resources by encouraging organizations to work together to identify common messages, leverage resources, and develop programs for populations at risk for diabetes, asthma, and obesity.
Community Partners Offer Financial Incentives and Support for Primary Care Practices, Improving Access and Reducing Utilization for Children on Medicaid
The Children's Healthcare Access Program offers financial incentives and support services to primary care medical homes serving children covered by Medicaid and their families; the program enhanced access to primary care, increased the percentage of children with asthma action plans, reduced emergency department visits and hospital admissions, increased well-child visits, and reduced costs.
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