Using Data to Better Serve the Most Complex Patients

Across the country, health care systems continue to grapple with how best to serve patients with the greatest needs. These complex care patients, sometimes referred to as super-utilizers, have comorbid and often serious conditions. Within Medicaid populations and other groups, such conditions often span both physical and behavioral health and are often further complicated by social factors, such as housing instability, poverty, or limited education. The National Governors Association worked with several states to develop statewide initiatives for improving the management of care for super-utilizers within state Medicaid programs. State leaders can learn to develop effective programs and policies for complex care patients by understanding the characteristics of complex populations, identifying and targeting specific patients and ensuring effective management and evaluation.

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