Transforming Care: Reporting on Health System Improvement

Transforming Care focuses on new models of care, payment approaches, and patient engagement strategies that have the potential to reshape our delivery system to better meet the needs of the nation’s sickest and most vulnerable patients. 

  • December 17, 2015 Issue
In Focus: Integrating Community Health Workers into Care Teams

Community health workers who help patients navigate the health care system and work to address their social and economic needs have rarely been fully integrated into care teams. This issue of Transforming Care reports on health care organizations that have integrated community health workers into multidisciplinary teams, which appears to be a factor in their success. 

Putting Health Coaches Front and Center: Q&A with Rushika Fernandopulle of Iora Health

Community health workers—or health coaches as Iora Health refers to them—play a dominant role in the Boston-based company’s primary care teams, helping to improve health outcomes by finding creative ways to engage and motivate patients.

Profile: Joseph Calderon, Community Health Worker for Transitions Clinic Network

Joseph Calderon, a community health worker for the Transitions Clinic Network, helps those newly released from prison establish relationships with primary care providers. His goal is to help parolees make the difficult transition from prison—where they were passive players in their care—to the health care system “outside the wall.” 

Publications of Note

Selected publications from the professional literature look at the role of insurance expansion in managing chronic conditions, ways to incorporate patients' goals into provider incentive programs, the costs of dementia care, and more.

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