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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.


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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