Attributes Common to Programs That Successfully Treat High-Need, High-Cost Individuals

Paper
Key Questions Answered
  • What are some common features of successful programs to better treat individuals with complex needs?
Key Themes and Takeaways

Based on a review of peer-reviewed and gray literature and interviews, this resource identified eight common attributes of many successful programs that provide better care for people with high needs and high costs of care.

  • Targeting is important, even within the group of high-need patients enrolled in a program. More successful programs typically stratify enrollees and provide additional services to certain participants; the key is to identify patients who are most amenable to change.
  • The leadership team should span a wide range of clinical and operational disciplines, including physicians, nurses, social workers, pharmacists, and operations personnel.
  • Developing close relationships among teams of nurses, social workers, and clinicians and between clinical teams and patients and family members is important. Successful programs are more likely to have care coordinators located in the physician’s office as opposed to remotely; frequent face-to-face interactions help build relationships and facilitate communication.
  • Most successful programs evolve over time, periodically updating the program to reflect new information about what is working and what is not. Many programs require a long period of sustained funding before the program begins to save on costs.
Authors
Gerard F. Anderson
Jeromie Ballreich
Sara Bleich
Cynthia Boyd
Eva DuGoff
Bruce Leff
Claudia Salzburg
Jennifer Wolff
Population Addressed
Adults Under 65 with Disabilities
Frail Older Adults
People with Multiple Chronic Conditions
Level of Evidence
Systematic Review (without Evidence Grading); Moderate Evidence
Uploaded to The Playbook