Demonstrates that intensive outpatient care programs show promise in reducing utilization and costs and improving patient outcomes for high-need, high-cost populations.
Integrated health care systems can better support high-risk patients by embedding high-risk patient care within general primary care and mental health care.
Accountable care organizations (ACOs) and tailored care coordination strategies may improve preventable hospitalizations and reduce racial disparities among patients with coexisting physical and mental health conditions.
Health care systems may need to tailor screening and referral approaches for social needs, as some needs may be less likely to be met by social service organizations.
Among high-cost Medicare enrollees, those who are seriously ill, frail, and/or had a serious mental illness experience the most potentially preventable spending.
Virginia’s comprehensive Medicaid reform for substance use treatment services led to an increase in outpatient and community-based treatment and a decrease in emergency department and inpatient use among beneficiaries with opioid use disorder.
Providing virtual case mentoring to outpatient care teams may reduce unnecessary hospital and emergency department visits for high-need, high-cost patients.
Integrating medical, behavioral health, and social services data tells a fuller story of frequent emergency department users’ service utilization and may identify candidates for care coordination.