Strategies to Reduce Costs and Improve Care for High-Utilizing Medicaid Patients: Reflections on Pioneering Programs

Key Questions Answered
  • What are the different models of care management for “high-utilizing” Medicaid beneficiaries?
Key Themes and Takeaways

This resource reviews 14 programs for people with complex needs that primarily benefit individuals insured through Medicaid.

  • The programs fall into various categories, such as the Emergency Department–Based Model, the Home-Based Model, and the Housing First Model.
  • Ten key factors emerged as themes for success, including a home visit component, a coaching philosophy, and an emphasis on medication adherence.  
  • The resource provides a close look at the cost and utilization data of five of the programs, including the Chicago Housing First program and the Atlantic City Special Care Center.
Thomas Bodenheimer
Population Addressed
People with Multiple Chronic Conditions
People with Behavioral Health and Social Needs
Level of Evidence
Non-systematic Review (without Evidence Grading)
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