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

Provider groups taking on risk for the overall costs of care in accountable care organizations are developing care management programs to improve care and thereby control costs. Many such programs target “high-need, high-cost” patients – those with multiple or complex conditions, often combined with behavioral health problems or socioeconomic challenges. This study compares the operational approaches of 18 successful complex care management programs in order to offer guidance to providers, payers, and policymakers on best practices for complex care management.