High-Need, High-Cost Segmentation Framework Segmentation framework with publicly available code files identifies specific and actionable patient cohorts with complex needs. Implementation Tool October 2021
Identifying Patients with Persistent Preventable Utilization Offers an Opportunity to Reduce Unnecessary Spending Medicare patients with the top five percent in preventable utilization account for almost half of all avoidable Medicare costs. Peer-Reviewed Article July 2020
Serving People with Severe Mental Illness who are Dually Eligible for Medicare and Medicaid Examines promising strategies to meet the needs of dually eligible individuals with serious mental illness, with an emphasis on opportunities to innovate with flexible spending within a capitated payment model. Peer-Reviewed Article June 2020
Effective Care for High-Need Patients: Opportunities for Improving Value, Outcomes and Health The National Academy of Medicine offers a synthesis of the evidence for improving care for high-needs patients. Brief/Report June 2017
High-Need, High-Cost Patients: Who Are They and How Do They Use Health Care? There is considerable variation in use and spending among high-need adults, suggesting this population should be segmented into subgroups. Brief/Report August 2016