Opportunities to Improve Models of Care for People with Complex Needs

Much has been learned about effective ways to organize, deliver and pay for care for high-cost patients. These efforts have collectively identified core elements of care models, financing strategies, data and analytic supports, workforce capacities, governance models, and regulatory frameworks that can improve outcomes and reduce costs for individuals who do not fare well under currently fragmented systems. Patients who have high levels of emergency department and hospital use highlight a number of psychosocial factors and life experiences that impact their care need.