Resources

A majority of mature accountable care organizations (ACOs) segment their high-need, high-cost (HNHC) population into smaller subgroups to better identify those with similar needs, employing a range of...
Approximately one in three Medicare beneficiaries is enrolled in a Medicare Advantage (MA) plan, and more than one third of these MA enrollees are classified as high need based on their chronic...
This resource describes four care management models that ACOs are using for individuals with complex needs. Care management programs can involve creating patient care plans, coordinating care across...
This resource describes recent changes in Medicare Advantage (MA) and their implications for plans. The Centers for Medicare and Medicaid Services (CMS) has recently reinterpreted several key aspects...
This resource examines three innovative models for treating patients with serious illness, developed by third-party firms that contract with Medicare Advantage plans. The financing structure of...
This resource features a recording of a WIHI audio program from the Institute for Healthcare Improvement, which featured Better Care Playbook faculty, including R. Corey Waller, MD, and Catherine...
This resource shares 10 questions that California’s Medicaid managed care plans are now required to ask patients about their social and functional needs. These questions could serve as a model for...
This resource provides a summary of key components of the Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act, which was passed and signed on February 9, 2018...
The Commonwealth Fund surveyed patients with complex needs from June to September of 2016, and an analysis of the results reveals that the health care system is failing to meet these patients’ needs...
This resource analyzes nationwide 2014 ED data across 13 geographically dispersed US states. Findings include: For ED visits covered by Medicaid, high-need, high-cost patients were on average older...
To inform the delivery of targeted care for the highest-need beneficiaries, this resource examines comorbidity patterns among Medicaid beneficiaries under 65 years old with disabilities. Key findings...
This resource describes opportunities to use digital health products for high-need, high-cost populations. It summarizes the results of the Super-Utilizer Health Innovation Challenge, run by the...