Programs Targeting Complex Patients — An Inventory

A relatively small number of patients with complex medical, social, and behavioral needs account for a large proportion of healthcare spending. To address this, a variety of programs have been developed that target high-need high-cost individuals with models of care specifically tailored to their needs. The following inventory contains profiles of nearly a hundred programs across 36 states and territories. To qualify for inclusion, programs must specifically target complex patients and go beyond medical care coordination to offer either a level of social services integration or a program that specifically addresses socioeconomic disparities. Programs or models operating in multiple states are listed under "Multistate."

Also see the Hub's Easy Explainer describing this project, a Research Brief, Addressing the Unmet Medical and Social Needs of Complex Patients, and our comprehensive resources page.

This listing of programs is a work in progress. If you know of a program that should be added, or have suggested changes to a program description, please let us know! You can send your suggestions to HubInfo@altarum.org.

Click on the state names below to see the programs in that state.

Multistate Initiatives