A group of experts identified 6 high-need populations and dimensions of successful care models to improve outcomes and reduce spending for these populations.
Health policy in the United States is shifting towards value-based care and, therefore, health organizations are focusing on the 5% of patients who are responsible for half of all healthcare costs. The National Academy of Medicine (NAM) in partnership with the Harvard T.H. Chan School of Public Health, the Bipartisan Policy, The Commonwealth Fund, and the Person Center on Healthcare, held workshops in order to advance the knowledge of how to best care for high-need patients, and published their findings in a report.
A recent article from JAMA Internal Medicine analyzed and summarized the different interventions for these patients that attempt to improve outcomes and reduce spending.
“High-need patients are a diverse group with high burden of medical comorbidities, functional limitations, disability, and social complexity,” the authors explained. “Therefore, different high-need segments require different services and workforce competencies to optimize patient care.”
The experts identified 6 high-need populations—children with complex needs, nonelderly disabled adults, frail elderly individuals, patients with major complex chronic conditions, patients with less severe but multiple chronic conditions, and patients with advancing illness.
The authors noted that determining these populations was necessary because each population of patients is unique and requires a customized strategy. Also, other than just the medical needs, the article noted the importance of considering the social, behavioral, and mental health factors within each population.
The experts also identified 4 dimensions of successful care models for high-need patients:
The experts also noted the obstacles physicians face in adopting more effective care models for their high-need patients. In order to overcome such challenges, physicians should participate in alternative payment models that allow integration of medical and social services and pay for all care of the patient.
Additionally, physicians and group practices should consider adoption of care models that target specific high-need patients. Clinicians should also work to track health outcomes, including patient-reported outcomes, for these populations.
“Too many of the current measures that target high-need patients focus on use of services, such as emergency department visits or hospitalizations,” the article concluded. “Clinicians have a critical role in both defining what is good care for these patients and how best to track it.”
What We’re Reading: FDA Approves UTI Antibiotic; Ozempic, Wegovy Price Investigation; US Births Fall
April 25th 2024The FDA recently approved an antibiotic for the treatment of urinary tract infections (UTIs) in women; a Senate committee recently launched an investigation into the prices of Novo Nordisk’s diabetes and weight loss drugs; US births fell last year, resuming a national slide after a previous increase during the pandemic.
Read More
Oncology Onward: A Conversation With Thyme Care CEO and Cofounder Robin Shah
October 2nd 2023Robin Shah, CEO of Thyme Care, which he founded in 2020 with Bobby Green, MD, president and chief medical officer, joins hosts Emeline Aviki, MD, MBA, and Stephen Schleicher, MD, MBA, to discuss his evolution as an entrepreneur in oncology care innovation and his goal of positively changing how patients experience the cancer system.
Listen
What We’re Reading: Abortion Privacy Rules; Alzheimer Drug Hurdles; Nursing Home Staffing Overhaul
April 23rd 2024New health privacy rules aim to protect patients and providers in an evolving abortion landscape; some physicians express concerns about efficacy, risks, and entrenched beliefs in treating Alzheimer disease; CMS addresses longstanding staffing deficits in nursing homes.
Read More
An Overview of Health Care and Pharmaceutical Trends, 2023-2024
April 19th 2024Douglas M. Long, BA, MBA, was featured as the keynote speaker on the closing day of The Academy of Managed Care Pharmacy 2024 annual meeting, with a session dedicated to surveying the health care and pharmaceutical trends of the last year.
Read More