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Complex Care 'Playbook' Addresses Medical, Social Needs

By John Commins  
   December 12, 2016

The newly formed National Center for Complex Health and Social Needs identifies best practices for improving care and lowering costs for patients facing myriad medical, behavioral, and social challenges.

Health systems, medical professionals and payers looking for effective ways to treat high-utilization patients that have complex medical and social needs have a new online resource.

Drafted at the Institute for Healthcare Improvement, The Playbook: Better Care for People with Complex Needs compiles and shares examples of successful approaches to care, guidance on making the business case for these models, and opportunities for policy and payment reform.

The playbook was unveiled Friday at the inaugural meeting of the National Center for Complex Health and Social Needs, led by Jeffrey Brenner, MD, of the Camden Coalition of Healthcare Providers.

"The care of complex patients is still in its infancy. We're still bloodletting people," says Brenner, a 2013 recipient of a MacArthur Foundation "genius grant," who has developed care models that address non-medical needs such as addiction, housing, hunger, and mental health.

"We have a system of misaligned incentives and incorrectly trained professionals," Brenner says. "We can transplant hearts and lungs, and cure cancer, but we haven't caught up to all that complexity. There is a human side to all of this that we just haven't figured out. We have a lot of implicit bias in our medical model about how we think about care, and we are missing some elements in that model."

Big Backers
The playbook has the backing of five national healthcare foundations—The John A. Hartford Foundation, the Peterson Center on Healthcare, the Robert Wood Johnson Foundation, The SCAN Foundation, and The Commonwealth Fund.

In a joint media release, the foundation leaders said that improved access to care that coordinates patients' medical, behavioral, and social needs means that high-needs complex patients will be less likely to delay care, or go to the emergency room for non-urgent care.

Patients with complex needs include older adults, people with major complex chronic conditions, and younger people with disabilities. Since many are older than 65, addressing this issue will become more urgent as the nation's population ages.

John Commins is a content specialist and online news editor for HealthLeaders, a Simplify Compliance brand.

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