US: Call for coordinated care for high-needs patients to improve outcomes and cut spending

With nearly half of US healthcare budgets accounted for by 5 per cent of patients, improving health outcomes and curbing spending requires those with high needs to be identified and provided with coordinated services through successful care models that link medical, behavioural, and community resources, according to a report from the National Academy of Medicine

The needs of this population extend beyond care for physical ailments, to social and behavioural. As a result, addressing clinical needs alone will not improve their health outcomes or reduce health care costs.

The report examines the key characteristics of high-needs patients; the use of a patient categorisation scheme, or a taxonomy, as a tool to inform and target care; promising care models and attributes to better serve high-needs patients; and areas of opportunity to support the spread and scale of evidence-based programmes.

“As the nation examines how to drive down the costs of healthcare, there are opportunities for action to improve the care and reduce the cost of delivering that care for one of the most expensive and challenging populations of the current health care system: high-needs patients,” said Victor Dzau, president of the National Academy of Medicine.

High-needs individuals are disproportionately older and less educated. They are also more likely to be publicly insured, have fair-to-poor self-reported health, and be susceptible to lack of coordination within the healthcare system. Therefore, improving outcomes for this population requires assurance of attention to an individual’s functional, social, and behavioural needs.

A number of barriers currently prevent the spread or sustainability of successful care models including the misalignment between financial incentives and the services necessary to care for high-needs patients, health system fragmentation, workforce training issues, and disparate data systems that cannot easily share needed information. The report discusses these barriers as well as strategies for addressing them.

Effective care for high needs patients: https://nam.edu/effective-care-for-high-need-patients/

 

 

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