In the United States, a small percentage of high-needs patients account for a disproportionately high share of medical care and costs. The emerging field of complex care aims to better understand the needs of these patients and promote best practices for hospitals.
In this new field, providers identify a subset of their patient population with complex health and social needs that require a more holistic, interdisciplinary approach to care. These individuals have clinically complex needs, functional limitations, and/or behavioral health conditions. They tend to use more health care services and cost more to treat but still have unmet needs.
The National Center for Complex Health and Social Needs (National Center), in partnership with the Institute for Healthcare Improvement and the Center for Health Care Strategies, developed the Blueprint for Complex Care. The blueprint, recently revealed at the National Center’s annual conference, assesses the current state of the complex care field and provides a strategic plan to advance the goals of the movement and improve care delivery for vulnerable patients. Developers had input from experts and front-line stakeholders on the goals, needs, and priorities of the complex care movement.
Essential Hospitals Institute Efforts in Complex Care
Essential Hospitals Institute, the research and quality arm of America’s Essential Hospitals, is committed to advancing the field of complex care, especially for hospitals serving a safety-net role. Kalpana Ramiah, DrPH, MSc, vice president of innovation at America’s Essential Hospitals and director of the Institute, represented essential hospitals at the National Center’s annual conference, where the blueprint was revealed. She contributed to a plenary session entitled “The Power of Partnership in Transformation,” which explored how meaningful partnerships between patients and health systems can create real and systematic changes, especially for patients with complex health and social needs.
The Institute also started a new project with the complex care team at NYC Health + Hospitals (NYC H+H) to develop the Complex Care Implementation Guide for Safety-Net Health Systems. This project, funded by the Commonwealth Fund, will leverage the National Academy of Medicine’s special publication Effective Care for High-Need Patients and build on the Better Care Playbook. While existing frameworks and implementation strategies can help identify and coordinate care for high-needs patients, efforts to understand complexity do not fully consider diversity or the reality essential hospitals face. The Institute will work with NYC H+H to convene an advisory group of systems-level leaders from safety-net health systems to vet and refine this implementation guide for complex care.