Segmentation framework with publicly available code files identifies specific and actionable patient cohorts with complex needs.

Using segmentation to address clinical and social needs for Medicaid patients with complex needs and costly utilization can improve the effectiveness of complex care programs.

Creating clinically meaningful profiles of patients with medically complex needs can support the delivery of more tailored interventions.

Health care organizations can use population-level data sources about the experiences of people with disabilities to improve care.

Summarizes different approaches and criteria that can be used to identify patients with complex needs for health system interventions.

Offers a practical framework for safety-net health systems to better identify and segment patients with complex needs, and tailor care models to meet their needs.

Medicare patients with the top five percent in preventable utilization account for almost half of all avoidable Medicare costs.

Among high-cost Medicare enrollees, those who are seriously ill, frail, and/or had a serious mental illness experience the most potentially preventable spending.

Using patient-self reported data instead of only utilization outcomes may enable better segmentation of older adults.

Assessing post-discharge needs.

Impact of social needs navigation program on future utilization of patients with prior high utilization.

When identifying patients with complex health needs for interventions, algorithms that rely on cost data as a proxy for health status may lead to under-identification of Black patients.

Accountable Care Organization leaders explore approaches to segmenting high-need, high-cost populations.

Predictive modeling to reduce ED utilization.

An international analysis of high-cost patients.

The What Matters Index measures quality of life for people with chronic conditions.

Describes the needs of distinct subpopulations within the dually eligible population with highly complex needs, along with opportunities for tailored interventions that may reduce health care spending.

The National Academy of Medicine offers a synthesis of the evidence for improving care for high-needs patients.

Segmenting the high-cost population is the first step in matching appropriate care management strategies.

A three-pronged strategy can help manage care for Medicare beneficiaries.