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High-need, high-cost (HNHC) individuals are defined as people of all ages living with clinically complex needs and functional limitations who also incur high health care costs or are likely to do so in the near future. Despite frequent contact with the health care system and substantial medical spending, the physical, social, and behavioral health needs of these individuals often remain unmet due to uncoordinated and fragmented care. Studies suggest that HNHC individuals could benefit from a more holistic approach that coordinates the care they receive and addresses their unmet social needs. Doing so could improve quality of care and quality of life while reducing health care service use.
This blog post is an initial effort to describe the types of programs that ACOs have in place to address the needs of HNHC populations and to identify the challenges they face in deploying these programs effectively. In late 2017, the Institute for Accountable Care conducted a qualitative research study to identify ACO strategies to improve care for HNHC populations, supported by the SCAN Foundation…