Tailoring Complex Care Management for High-Need, High-Cost Patients

David Blumenthal
Melinda K. Abrams
Journal Article

This viewpoint article argues that policy can play an important role in improving outcomes for people with complex needs in the US, and it makes several recommendations for the current federal administration.

  • Policymakers should accelerate the transition from fee-for-service payment to value-based payment, such as accountable care organizations, to incentivize health systems to improve patients’ health at lower costs.
  • Policy should allow payers to cover non-medical services that affect health outcomes of people with complex needs, such as transportation and nutrition support.
  • Policymakers should encourage seamless information exchange through electronic health records and other digital infrastructure.
  • Policy should encourage experimentation with new care models and research to evaluate their effectiveness in improving outcomes for people with complex needs.
Posted to The Playbook on
Population Addressed
Adults Under 65 with Disabilities
People with Advanced Illness
Frail Older Adults
People with Multiple Chronic Conditions
People with Behavioral Health and Social Needs
Key Questions Answered
  • What are some policy changes that can promote better care management at lower cost for people with complex needs?
Level of Evidence
Expert Opinion
What does this mean?