CHaSCI’s social-work-led care management models provide protocol and an evidence base
to guide the integration of medical and person-centered, family-oriented social care.

Testing innovations such as universal screenings for unmet psychosocial needs
help expand our impact and engage more individuals who face barriers to health.


CHaSCI’s Bridge and AIMS (Ambulatory Integration of Medical and Social) care models emphasize hospital-community collaboration and can be implemented by healthcare entities or community-based organizations.

Bridge and AIMS evolve to meet the needs of the changing US health care system as we continue learning from implementation successes and challenges at Rush University Medical Center, Aging Care Connections in partnership with AMITA Health, and 100+ sites trained in the models around the country.

As demonstrated by Bridge and AIMS, integrating medical and social care leads to many positive outcomes:

  • increased primary care engagement

  • significantly lower hospitalization & readmission rates

  • decreased depressive symptoms & stress for patients & family caregivers


Want to learn more about CHaSCI’s experience with care management and other care innovations? Click here.

Interested in learning more about replication and technical assistance opportunities? Contact us.