Find the Right Tool for the Job
We offer free tools and resources to improve health care quality, efficiency, and value. These resources are designed to engage patients and support providers' quality improvement efforts. You can search by name or filter by category and type.
ADA: Plan Your Diabetes Plate
An American Diabetes Association (ADA) handout that explains how to use the Diabetes Plate method to build balanced meals that help manage blood glucose.
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ADA: Plan Your Diabetes Plate (Spanish)
Spanish version of an ADA handout that explains how to use the Diabetes Plate method to build balanced meals that help manage blood glucose.
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ADA: Plan Your Portion Plate
An American Diabetes Association (ADA) placemat that uses a photo of a sample meal on a 9-inch plate to show how to portion food for diabetes management.
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ADA: Plan Your Portion Plate (Spanish)
Spanish version of an ADA placemat that uses a photo of a sample meal on a 9-inch plate to show how to portion food for diabetes management.
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Live Well with Diabetes
A patient flyer introducing the Diabetes Self-Management Education and Support (DSMES) program.
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Pre-Diabetes: Could It Be You?
A CDC infographic explaining prediabetes and its links to Type 2 diabetes, heart disease, and stroke, as well as information about joining a CDC-recognized diabetes prevention program.
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AMA MAP: Preventing Diabetes
AMA MAP™ Prediabetes is an American Medical Association (AMA) framework that helps health care organizations adopt and execute strategies to prevent type 2 diabetes by measuring accurately, acting rapidly, and partnering with patients.
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YMCA's Diabetes Prevention Program
Learn about the YMCA's Diabetes Prevention Program, a year-long program that engages participants in 25 sessions and focuses on small, measurable lifestyle goals to help adults with prediabetes eat healthier, be more active, and lose weight.
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Quick Guide to SDOH Coding & Billing
A guide to explain social determinants of health (SDOH) screening and how to bill and code for it.
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Diabetes Prevention Impact Toolkit
An online calculator that lets states, employers, and insurers project the health and economic effects of the National DPP lifestyle change program on their population at risk for diabetes, including potential return on investment.
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National DPP: Find a Program
CDC webpage that helps people find a National Diabetes Prevention Program lifestyle change program by entering a city, state, or zip code.
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Free Apps to Help You Better Manage Your Medications
A list of free mobile apps that help patients and caregivers manage medications through dose and refill reminders, drug interaction alerts, health tracking, and shareable reports for their doctor.
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Managing Diabetes: Medicare Coverage & Resources
An outline of 10 steps for people living with diabetes, Medicare coverage for diabetes testing supplies, medications, and self-management training, and programs that can help with costs.
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Diabetes Self-Management Program (DSMP)
Information about the free, evidence-based Diabetes Self-Management Program (DSMP), a six-week series of small-group classes offered in person or virtually that teaches adults with diabetes skills for managing symptoms, staying active, using medications correctly, eating well, and communicating with their health care team.
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PA Navigate
A resource and referral tool, sponsored by the PA Department of Human Services, that lets residents search for local social services or self-refer, and lets health care providers and community-based organizations send & track outbound referrals to address patients’ social determinants of health.
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HealthBegins: Risk Screening Tools Review
A tool with 28 questions assessing domains like economic stability, education, social and community context, neighborhood and physical environment, and food.
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Wireless Phone Resources
A resource that explains the Federal Communications Commission's (FCC) Lifeline program, which offers discounted phone and internet service to eligible low-income households.
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Diabetes in PA: An Infographic
An outline of the impact of diabetes in PA.
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Medicaid MCO Fitness Coverage: Lehigh/Capital Region
A list of contact information and QR codes for local Medicaid managed care plans for people with Medicaid in PA’s Lehigh/Capital region to help members find covered fitness centers, YMCAs, and exercise and nutrition programs.
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Medicaid MCO Fitness Coverage - NE PA Region
A list of contact information and QR codes for local Medicaid managed care plans for people with Medicaid in PA’s Northeast region to help members find covered fitness centers, YMCAs, and exercise and nutrition programs.
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Medicaid MCO Fitness Coverage - NW PA Region
A list of contact information and QR codes for local Medicaid managed care plans for people with Medicaid in PA’s Northwest region to help members find covered fitness centers, YMCAs, and exercise and nutrition programs.
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Medicaid MCO Fitness Coverage - SE PA Region
A list of contact information and QR codes for local Medicaid managed care plans for people with Medicaid in PA’s Southeast region to help members find covered fitness centers, YMCAs, and exercise and nutrition programs.
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Medicaid MCO Fitness Coverage - SW PA Region
A list of contact information and QR codes for local Medicaid managed care plans for people with Medicaid in PA’s Southwest region to help members find covered fitness centers, YMCAs, and exercise and nutrition programs.
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Lehigh Valley Diabetes Programs
A list of diabetes management program options in the Lehigh Valley and nationwide with links and QR codes to sign up.
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Northeast PA Diabetes Programs
A list of diabetes management program options in the Northeast PA region and nationwide with links and QR codes to sign up.
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Northwest PA Diabetes Programs
A list of diabetes management program options in the Northwest PA region and nationwide with links and QR codes to sign up.
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South Central PA Diabetes Programs
A list of diabetes management program options in the South Central PA region and nationwide with links and QR codes to sign up.
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Southeast PA Diabetes Programs
A list of diabetes management program options in the Southeast PA region and nationwide with links and QR codes to sign up.
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National Diabetes Prevention Program - YMCAs (WMCHC)
An introduction to the National Diabetes Prevention Program (NDPP) with contact information for five northeastern PA YMCAs that offer the program and a link to the CDC’s program registry.
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Feeding PA - Find Your Food Bank
The Feeding Pennsylvania food bank locator helps residents find food assistance by entering a ZIP code to find food pantries in their area or filtering by county.
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Unite Pennsylvania
Information about Unite Pennsylvania, a coordinated care network consisting of healthcare, government, nonprofit, and other organizations that use Unite Us to find, deliver, and pay for services that meet community members’ social needs.
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Findhelp.org (Aunt Bertha)
A free nationwide online directory to help individuals connect with resources and services in their community that are free or at a reduced cost.
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PA 211
A free, confidential statewide service that connects PA residents with local help for needs like utility bills, housing, food, and employment.
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PRAPARE Screening Tool (English)
PRAPARE, developed by the National Association of Community Health Centers and its partners, is a standardized patient screening tool that asks about personal characteristics, family and home, money and resources, and social and emotional health to help health care teams identify and respond to patients’ social risks and needs.
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PRAPARE Screening Tool (Spanish)
Spanish version of PRAPARE, developed by the National Association of Community Health Centers and its partners, which is a standardized patient screening tool that asks about personal characteristics, family and home, money and resources, and social and emotional health to help health care teams identify and respond to patients’ social risks and needs.
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Health Leads Social Needs Screening Toolkit
A toolkit to help health care organizations screen patients for social needs, outlining essential and optional social need domains, five keys to an effective screening tool, a recommended screening tool in English and Spanish, and a library of validated screening questions rated by precision and reading level.
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CMS: Health Social Needs Screening Tool
The Accountable Health Communities (AHC) Health-Related Social Needs (HRSN) Screening Tool, developed by CMS, explains the purpose of screening and provides 10 core questions on housing instability, food insecurity, transportation, utilities, and interpersonal safety to help providers identify patients’ unmet social needs and refer them to community services.
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AAFP Social Needs Screening Tool
This American Academy of Family Physicians social needs screening tool, part of The EveryONE Project, includes 15 questions that help practices identify patients’ needs.
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AHEC National DPP Fax Cover Sheet
This Northeast Pennsylvania Area Health Education Center (AHEC) fax referral form lets providers refer patients with prediabetes to the National Diabetes Prevention Program (NDPP).
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Medication Adherence Office Protocol
A template protocol to help practices make medication adherence assessment part of every office visit.
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Pharmacy & Support Services Resources
A list of pharmacy and support resources to help patients lower prescription costs and find financial, caregiving, and community support services.
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Diabetes Management Apps
A flyer highlighting eight phone apps that help people with diabetes track blood sugar, medications, food, exercise, and other health data, with many offering reports to share with their doctor.
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IHI Model for Improvement: Forming the Team
Learn how to form a quality improvement team under the Institute for Healthcare Improvement's (IHI) Model for Improvement.
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National Diabetes Prevention Program (NDPP)
Introducing the National Diabetes Prevention Program (NDPP), a yearlong lifestyle change program offered online or in person in PA.
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Didn't Find What You Need?
Are you searching for a resource that you did not find here but would like for your practice and/or your patients? Please contact your Quality Insights Practice Transformation Specialist or email Ashley Biscardi, Project Lead, for assistance.