There is increasing recognition that the US healthcare system fails individuals with the most complex health and social needs, including many who repeatedly cycle through multiple healthcare, social service, and other systems without lasting improvements to their health or wellbeing. To see different results we must deliver care differently: care must be flexible, interdisciplinary, evidence-based, and centered on the needs, goals, and circumstances of the individual.
Complex care is a person-centered approach to address the needs of people whose combinations of medical, behavioral health, and social challenges result in extreme patterns of healthcare utilization and cost. Complex care works at the individual and systemic levels: it coordinates better care for individuals while reshaping ecosystems of services and healthcare. By better addressing complex needs, complex care can reduce unnecessary spending in both healthcare and social services sectors.
At its heart, complex care seeks to be:
- Person-centered: Complex care begins with the human being, their strengths and their goals, and leverages their relationships and natural daily structures to heal and sustain them.
- Equitable: Complex care recognizes the structural barriers to health and supports consumers and communities to address them.
- Cross-sector: Complex care works to break down the silos dividing fields, sectors, and specialties, and to build the integrated ecosystem necessary to provide whole-person care.
- Team-based: Complex care is delivered through interprofessional, non-traditional, and inclusive teams of medical, behavioral health, and social service providers, led by the individual themselves.
- Data-driven: Complex care freely shares timely, cross-sector data across team members and partners to identify individuals, enable effective support of consumer goals, and evaluate success.
The National Center for Complex Health and Social Needs serves as a professional home for the growing field of complex care. Want to learn more? Read our Blueprint for Complex Care.