Financing a Complex Care Model

October 2018

On October 30, 2018, the Playbook convened a panel of leading complex care experts to address emerging best practices related to financing a complex care model. They addressed the following questions:

  • How do you create a strong business argument for initial investment in complex care?
  • How do you partner with community-based organizations and other entities to address social determinants of health?
  • How is the landscape projected to evolve going forward?

This interactive online discussion, moderated by Kedar Mate, MD, Chief Innovation and Education Officer at the Institute for Healthcare Improvement, provided opportunities to share ideas and ask questions about how to make the finances work for complex care. 

Here were a few of the takeaways:

  • It’s not just a matter of having the right concepts, said Ken Coburn, MD, DrPH, President, CEO, and Medical Director of Health Quality Partners. Making the finances work has to involve diligent design and disciplined implementation to operationalize those concepts.  
  • Innovation is key, said Carolyn Ingram, MBA, Senior Vice President, Policy and Government Affairs, Molina Healthcare, Inc. Health care organizations need to work with insurance companies, community health workers, and community-based organizations to bundle services in both health care and social care.   
  • Care for patients with complex needs must be multifactorial, said David Pryor, MD, Executive Vice President and Chief Clinical Officer, Ascension Health. While finances are important, it’s essential to get the care right first, and then find a business model that works. 

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