Our literature review uncovered five interventions with: (1) strong evidence of positive outcomes on utilization or health indicators associated with lower costs; and (2) significant roles for nurses and people who are not medically trained, both of whom are often members of faith-based or community-based organizations. “TEXT ME” sends people with coronary heart disease regular text messages that promote lifestyle changes; and “Project RED” engages discharge educators and pharmacists to help with hospital-to-home transitions. Three other interventions require more work from community members: the Community Asthma Intervention (target population: asthmatic children), Project Sugar (target population: adult diabetics), and “IMPaCT” (target population: newly discharged patients).