Patients with complex needs are often described as the 5 percent of patients who account for 50 percent of health care spending. Behind that oft-cited statistic are the individuals who make up that population – all of whom have their own stories and needs.

In a new Playbook video, David Blumenthal, MD, MPP, president of the Commonwealth Fund, offers insight into the individuals within the group with the story of “Mrs. D,” a patient he cared for.

Recently, the National Academy of Medicine (NAM) convened experts and stakeholders to explore the key attributes of patients with complex needs and devise a course of action for improving care for this patient population.

Marit Tanke, MD, PhD, a Commonwealth Fund Harkness Fellow, led a research project to analyze high-need, high-cost patients across four countries — the United States, the Netherlands, Canada, and Germany.

What did she learn? The US is not the only country with a high proportion of health care spending concentrated in a small number of patients.

How can health systems improve care for patients with complex needs?

They can start by asking, “Who?”

Jose Figueroa, MD, MPH, a hospitalist at Brigham and Women’s Hospital and a health services researcher at Harvard School of Public Health and Harvard Medical School, has been researching this question: Who are patients with complex needs?

Dr. Figueroa was part of a team convened by the National Academies of Medicine (NAM) that created a model for identifying population segments within the broad category of high-need, high-cost patients.

Welcome to the Better Care Playbook. Here we’ll introduce you to the Playbook and suggest some ways to get the most out of it.

The Better Care Playbook is part of an effort led by six national foundations to offer you the latest information and resources on how to provide better care for people with complex medical, behavioral health, and social needs. The rapidly evolving policy and payment environment is creating considerable pressure to change, and change fast.