Skip to main content

Advanced Search

Advanced Search

Current Filters

Filter your query

Publication Types

Other

to

Issue Briefs

/

Caring for High-Need, High-Cost Patients: What Makes for a Successful Care Management Program?

doctor patient health care wellness nurse

Overview

Provider groups taking on risk for the overall costs of care in accountable care organizations are developing care management programs to improve care and thereby control costs. Many such programs target “high-need, high-cost” patients: those with multiple or complex conditions, often combined with behavioral health problems or socioeconomic challenges. In this study we compared the operational approaches of 18 successful complex care management programs in order to offer guidance to providers, payers, and policymakers on best practices for complex care management. We found that effective programs customize their approach to their local contexts and caseloads; use a combination of qualitative and quantitative methods to identify patients; consider care coordination one of their key roles; focus on building trusting relationships with patients as well as their primary care providers; match team composition and interventions to patient needs; offer specialized training for team members; and use technology to bolster their efforts.

Publication Details

Date

Contact

Clemens S. Hong, Physician Researcher, General Medicine Division, Massachusetts General Hospital

[email protected]

Citation

C. S. Hong, A. L. Siegel, and T. G. Ferris, Caring for High-Need, High-Cost Patients: What Makes for a Successful Care Management Program? The Commonwealth Fund, August 2014.