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What Makes a Successful Care Management Program for High-Need, High-Cost Patients?

Care management of patients with multiple or complex conditions has an added importance with the emergence of accountable care organizations and bundled payments. A new report from the Commonwealth Foundation examines 18 successful care management programs to find best practices. The most effective programs had these attributes:

  • Customized approach to local contexts and caseloads
  • Use of both qualitative and quantitative methods to identify patients
  • Key emphasis on care coordination
  • Focus on creating trusted relationships with patients and their primary care providers
  • Matching team composition and interventions to patient needs
  • Specialized training for team members
  • Supporting care team efforts with technology

The report lists and summarizes each of the 18 programs studied, including outcomes on utilization, cost, and quality.

Sources:

Hong CS and others. Caring for high-need, high-cost patients: what makes for a successful care management program? Issue Brief, Commonwealth Fund, Aug. 7, 2014. http://www.commonwealthfund.org/~/media/files/publications/issue-brief/2014/aug/1764_hong_caring_for_high_need_high_cost_patients_ccm_ib.pdf

Hong CS and others. Perspective: Toward increased adoption of complex care management. New England Journal of Medicine 371: 491-493, Aug. 7, 2014. http://www.nejm.org/doi/full/10.1056/NEJMp1401755

Posted by AHA Resource Center (312) 422-2050, rc@aha.org

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