Targeted Resources Recommended for High-Need, High-Cost Patients

Management of High-Need, High-Cost Patients: A “Best Fit” Framework Synthesis, Realist Review, and Systematic Review, a new report from AHRQ’s Effective Health Care Program, found individualized, tailored patient engagement and resources to support providers can optimize interventions for high-need, high-cost patients.

The review assessed criteria that identify high-need, high-cost (HNHC) patients, developed theories on how to optimize interventions for HNHC patients and assessed the effectiveness of interventions. HNHC patients are defined as a very small number of patients who account for disproportionately high healthcare use and cost. The report found that HNHC patients often had multiple chronic conditions, a history of inappropriately high use of costly healthcare services, mental health conditions and social risk factors (such as homelessness). It also found that models based in the emergency department (ED) resulted in a reduction in all-cause ED visits, while ED- and primary care-based models resulted in a reduction of all-cause admissions. 

Select to access Management of High-Need, High-Cost Patients: A “Best Fit” Framework Synthesis, Realist Review, and Systematic Review.