NEJM January 31, 2019
Effective management of high-need, high-cost individuals is integral to the success and sustainability of a value-driven health care system. These patients make up 5% of the population but account for more than 50% of U.S. health care spend. Complex care management programs coordinate essential services, address critical gaps in communication, and prevent costly, avoidable hospitalizations and other urgent care services. Evolving innovative programs even incorporate nonmedical services such as transportation, housing assistance, and proper nutrition, which address the broader socioeconomic influences of health. Ultimately, complex care management is one of the best available tools to prevent costly and unnecessary use of the health care system — and improve patient outcomes in the process.
Yet despite strong supporting evidence, robust complex...