High-Need, High-Cost Segmentation Framework Segmentation framework with publicly available code files identifies specific and actionable patient cohorts with complex needs. Implementation Tool October 2021
High-Frequency Hospital Users: The Tail that Wags the Readmissions Dog Use of hospital readmission rates to measure quality may be unfair for some accountable care organizations and safety-net providers, since members with complex medical and social needs are a main driver of these rates. Peer-Reviewed Article June 2021
Identifying Patients with Persistent Preventable Utilization Offers an Opportunity to Reduce Unnecessary Spending Medicare patients with the top five percent in preventable utilization account for almost half of all avoidable Medicare costs. Peer-Reviewed Article July 2020
How Accountable Care Organizations Use Population Segmentation to Care for High-Need, High-Cost Patients Accountable Care Organization leaders explore approaches to segmenting high-need, high-cost populations. Brief/Report January 2019
Effective Care for High-Need Patients: Opportunities for Improving Value, Outcomes and Health The National Academy of Medicine offers a synthesis of the evidence for improving care for high-needs patients. Brief/Report June 2017
High-Need, High-Cost Patients: Who Are They and How Do They Use Health Care? There is considerable variation in use and spending among high-need adults, suggesting this population should be segmented into subgroups. Brief/Report August 2016