High-Need, High-Cost Segmentation Framework
Segmentation framework with publicly available code files identifies specific and actionable patient cohorts with complex needs.
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Displaying 1 - 7 of 7
Serving People with Severe Mental Illness who are Dually Eligible for Medicare and Medicaid
Examines promising strategies to meet the needs of dually eligible individuals with serious mental illness, with an emphasis on opportunities to innovate with flexible spending within a capitated payment model.
Peer-Reviewed Article
High-Cost Dual Eligibles' Service Use Demonstrates the Need for Supportive and Palliative Models of Care
Describes the needs of distinct subpopulations within the dually eligible population with highly complex needs, along with opportunities for tailored interventions that may reduce health care spending.
Peer-Reviewed Article
Impact of Complex Care Management on Spending and Utilization for High-Need, High-Cost Medicaid Patients
Complex care management program for high-need, high-cost Medicaid patients demonstrates substantially lower spending and inpatient utilization.
Peer-Reviewed Article
Outpatient Complex Case Management: Health System-Tailored Risk Stratification Taxonomy to Identify High-Cost, High-Need Patients
Maximizing the impact of outpatient complex case management.
Peer-Reviewed Article
Persistence and Drivers of High-Cost Status Among Dual-Eligible Medicare and Medicaid Beneficiaries
Analyzes the largest drivers of high costs among persistently high-cost Medicare-Medicaid beneficiaries, and finds most spending related to long-term care.
Peer-Reviewed Article
Effective Care for High-Need Patients: Opportunities for Improving Value, Outcomes and Health
The National Academy of Medicine offers a synthesis of the evidence for improving care for high-needs patients.
Brief/Report