This project will provide data and insights to U.S. policymakers and health system leaders about some of the novel approaches other countries have adopted to manage care and control costs for high-need, high-cost patients. Under a previous grant, the research team established international collaborations, explored the availability and comparability of cross‐national cost and utilization data, and conducted preliminary analyses to compare the care pathways for four different types of complex patients. The team will expand that work to learn why the U.S. is so often an outlier on health system performance and to identify the combinations and intensity of services and care models that lead to lower costs and better quality.