Provider groups taking on risk for the overall costs of care in accountable care organizations are developing care management programs to improve care and thereby control costs. Many such programs target “high-need, high-cost” patients: those with multiple or complex conditions, often combined with behavioral health problems or socioeconomic challenges. In this study we compared the operational approaches of 18 successful complex care management programs in order to offer guidance to providers, payers, and policymakers on best practices for complex care management. We found that effective programs customize their approach to their local contexts and caseloads; use a combination of qualitative and quantitative methods to identify patients; consider care coordination one of their key roles; focus on building trusting relationships with patients as well as their primary care providers; match team composition and interventions to patient needs; offer specialized training for team members; and use technology to bolster their efforts.
C4 -This grey literature reference is included in the Academy's Literature Collection in keeping with our mission to gather all sources of information on integration. Grey literature is comprised of materials that are not made available through traditional publishing avenues. Often, the information from unpublished resources can be limited and the risk of bias cannot be determined.
C5 - Grey Literature; Financing & Sustainability CA - 365.02 KB CY - New York, NY L3 - 365.02 KB N2 -Provider groups taking on risk for the overall costs of care in accountable care organizations are developing care management programs to improve care and thereby control costs. Many such programs target “high-need, high-cost” patients: those with multiple or complex conditions, often combined with behavioral health problems or socioeconomic challenges. In this study we compared the operational approaches of 18 successful complex care management programs in order to offer guidance to providers, payers, and policymakers on best practices for complex care management. We found that effective programs customize their approach to their local contexts and caseloads; use a combination of qualitative and quantitative methods to identify patients; consider care coordination one of their key roles; focus on building trusting relationships with patients as well as their primary care providers; match team composition and interventions to patient needs; offer specialized training for team members; and use technology to bolster their efforts.
PB - The Commonwealth Fund PP - New York, NY PY - 2014 RN - https://www.commonwealthfund.org/sites/default/files/documents/___media_files_publications_issue_brief_2014_aug_1764_hong_caring_for_high_need_high_cost_patients_ccm_ib.pdf T1 - Caring for High-Need, High-Cost Patients: What Makes for A Successful Care Management Program? TI - Caring for High-Need, High-Cost Patients: What Makes for A Successful Care Management Program? U1 - Grey Literature; Financing & Sustainability U4 -This grey literature reference is included in the Academy's Literature Collection in keeping with our mission to gather all sources of information on integration. Grey literature is comprised of materials that are not made available through traditional publishing avenues. Often, the information from unpublished resources can be limited and the risk of bias cannot be determined.
U5 - https://www.commonwealthfund.org/sites/default/files/documents/___media_files_publications_issue_brief_2014_aug_1764_hong_caring_for_high_need_high_cost_patients_ccm_ib.pdf UR - https://www.commonwealthfund.org/sites/default/files/documents/___media_files_publications_issue_brief_2014_aug_1764_hong_caring_for_high_need_high_cost_patients_ccm_ib.pdf Y1 - 2014 ER -