A significant proportion of health expenditures are concentrated within a small population of medically complex individuals. Identifying and managing care for this group of patients is an important step towards improving health outcomes and reducing total costs for the entire population.
The Health Care Transformation Task Force, a consortium of patients, payers, providers and purchasers working to transform the U.S. health care system, works to address this issue through its Improving Care for High-Cost Patients Work Group.
The Work Group recently released the third and final in a series of white papers, entitled “Payment to Promote Sustainability of Care Management Models for High-Cost, High-Need Patients." It outlines emerging payer and provider partnerships that incentivize sustainable delivery system re-engineering to improve care through innovative value-based payment models. It finds that the fee-for-service payment system has and continues to impede broad adoption of effective interventions for high-need, high-cost patients. Further, it notes that conflicting requirements and methodologies from multiple payers threaten to hinder progress in the future, even in supportive environments.