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Supporting a culture of health for high-need, high-cost populations: opportunities to improve models of care for people with complex needs
Supporting a culture of health for high-need, high-cost populations: opportunities to improve models of care for people with complex needs
- Collection:
- Health Policy and Services Research
- Author(s):
- Thomas-Henkel, Caitlin, author
Hamblin, Allison, author
Hendricks, Taylor, author - Contributor(s):
- Center for Health Care Strategies, Inc., issuing body.
Robert Wood Johnson Foundation, issuing body. - Publication:
- [Princeton, New Jersey] : Robert Wood Johnson Foundation ; [Hamilton, New Jersey] : Center for Health Care Strategies, Inc., November 2015
- Language(s):
- English
- Format:
- Text
- Subject(s):
- Health Services Needs and Demand
Vulnerable Populations
Models, Theoretical
Outcome and Process Assessment, Health Care
Social Determinants of Health
United States - Genre(s):
- Technical Report
- Abstract:
- With rapid health care transformation efforts underway across the nation, there is increasing attention on improving outcomes and reducing avoidable health care costs for the small subset of individuals who account for the majority of health care spending. As innovative models continue to emerge, policymakers, payers and providers are eager to identify and scale effective strategies for serving these high-need, high-cost patients, as one component of broader efforts to build more efficient and sustainable systems of care. Thanks to the efforts of innovative leaders in the field over the last decade, much has been learned about effective ways to organize, deliver and pay for care for high-cost patients. These efforts have collectively identified core elements of care models, financing strategies, data and analytic supports, workforce capacities, governance models, and regulatory frameworks that can improve outcomes and reduce costs for individuals who do not fare well under currently fragmented systems. Perhaps most importantly, these efforts have contributed to a growing appreciation for social determinants of health as key drivers of health care utilization. However, despite these advances, significant gaps in understanding remain--including, for example, how to: identify and engage individuals; segment populations into meaningful subgroups with tailored interventions; measure quality outcomes; and align financial incentives across systems. This report aims to identify those opportunities that warrant further exploration, with the hopes of targeting future investments and pilot activities to help fill the gaps that remain. Such exploration, and the resulting insights to be gleaned, will be critical to ensuring that the models that are currently being implemented at rapid pace have the maximum shot at delivering on their promise--to improve the health of individuals with very complex needs, and in doing so, to bend the trend in health care spending for the system overall. States, providers and payers are seeding, scaling and spreading innovative strategies that support high-need, high-cost patient populations to drive outcomes, reduce disparities, and bring down the cost of health care. This paper explores promising approaches ranging from pilot projects to statewide efforts, and identifies key opportunities for future investment and program development across the following domains: (1) Care model enhancements (2) Financing and accountability (3) Data and analytics (4) Workforce development (5) Governance and operations; and (6) Policy and advocacy.
- Copyright:
- Reproduced with permission of the copyright holder. Further use of the material is subject to CC BY license. (More information)
- Extent:
- 1 online resource (1 PDF file (27 pages))
- Illustrations:
- Illustrations and Portraits
- NLM Unique ID:
- 101673198 (See catalog record)
- Permanent Link:
- http://resource.nlm.nih.gov/101673198