Effect of Intensive Interdisciplinary Transitional Care for High-Need, High-Cost Patients on Quality, Outcomes, and Costs: a Quasi-Experimental Study

[1] Kaufman S(2014)Early efforts to target and enroll high-risk diabetic patients into urban community-based programs Health Promot Pract 15 62S-70S

[2] Ali N(2017)For super-utilizers, integrated care offers a new path Health Aff (Millwood) 36 394-7

[3] DeFiglio V(2014)Caring for high-need, high-cost patients: what makes for a successful care management program? Issue Brief (Commonw Fund) 19 1-19

[4] Craig K(2014)Toward increased adoption of complex care management N Engl J Med 371 491-3

[5] Brenner J(2012)Transitional care: focusing on patient-centered outcomes and simplicity Ann Intern Med 157 448-9

[6] Vaida B(2014)Transitional care interventions to prevent readmissions for persons with heart failure: a systematic review and meta-analysis Ann Intern Med 160 774-84

[7] Hong CS(2016)High-need, high-cost patients: who are they and how do they use health care? a population-based vomparison of demographics, health care use, and expenditures Issue Brief (Commonw Fund) 26 1-14

[8] Siegal AL(2017)Segmenting high-cost Medicare patients into potentially actionable cohorts Healthc (Amst) 5 62-7

[9] Ferris TG(2003)Falling through the cracks: challenges and opportunities for improving transitional care for persons with continuous complex care needs J Am Geriatr Soc 51 549-55

[10] Hong CS(2005)Posthospital medication discrepancies: prevalence and contributing factors Arch Intern Med 165 1842-7

[1] Kaufman S(2014)Early efforts to target and enroll high-risk diabetic patients into urban community-based programs Health Promot Pract 15 62S-70S

[2] Ali N(2017)For super-utilizers, integrated care offers a new path Health Aff (Millwood) 36 394-7

[3] DeFiglio V(2014)Caring for high-need, high-cost patients: what makes for a successful care management program? Issue Brief (Commonw Fund) 19 1-19

[4] Craig K(2014)Toward increased adoption of complex care management N Engl J Med 371 491-3

[5] Brenner J(2012)Transitional care: focusing on patient-centered outcomes and simplicity Ann Intern Med 157 448-9

[6] Vaida B(2014)Transitional care interventions to prevent readmissions for persons with heart failure: a systematic review and meta-analysis Ann Intern Med 160 774-84

[7] Hong CS(2016)High-need, high-cost patients: who are they and how do they use health care? a population-based vomparison of demographics, health care use, and expenditures Issue Brief (Commonw Fund) 26 1-14

[8] Siegal AL(2017)Segmenting high-cost Medicare patients into potentially actionable cohorts Healthc (Amst) 5 62-7

[9] Ferris TG(2003)Falling through the cracks: challenges and opportunities for improving transitional care for persons with continuous complex care needs J Am Geriatr Soc 51 549-55

[10] Hong CS(2005)Posthospital medication discrepancies: prevalence and contributing factors Arch Intern Med 165 1842-7