Complex care ecosystems are a core strategy and framework for communities looking to work together to support people with complex health and social needs.

On this page you’ll find:

What is a complex care ecosystem?

Released in the fall of 2018, the Blueprint for Complex Care, borrowed language from environmentalists in calling for the creation of complex care ecosystems.

A complex care ecosystem is a local network of organizations, sectors, fields, and/or professions working collectively to address the root causes of poor health among individuals with complex health and social needs.

Complex care ecosystems may include: 

  • consumers and families, 
  • health systems and practitioners, 
  • diverse community-based organizations, 
  • public health thinkers and doers, 
  • social service and behavioral health organizations, 
  • payers, 
  • educators, 
  • first responders, 
  • faith-based organizations, and more.

“Core to an ecosystem and its strength is interdependence—from small community-based non-profits to large hospital networks. Also key to our success is cherishing the idiosyncratic nature of local ecosystems. Real interconnectedness requires real authenticity—between and among patients, helpers, and communities. The most powerful examples of successful complex care ecosystems feature local and regional communities coming together, honestly evaluating their systems, understanding who’s at the table, and identifying who’s missing and marginalized. This is the hard work of building authentic, healing relationships—and it’s absolutely necessary.”

— Camden Coalition CEO Kathleen Noonan, from her Putting Care at the Center 2019 opening remarks

Why does complex care take an ecosystem?

The interdependent collaborations that characterize complex care ecosystems ​​improve effectiveness, efficiency, experience, and quality of care delivery by:

  1. Sharing information. Sharing real-time, detailed information from multiple sources (i.e., community-based organizations, public health, and health systems) on an individual’s conditions, circumstances, and goals means all providers have a holistic view of the individual and can tailor care accordingly.
  2. Leveraging existing trust and relationships. Community-based organizations may operate closer to where people live and have a deeper understanding of the population and community they serve. As a result, they are well-positioned to leverage strong, trusting relationships that allow for better care.
  3. Specializing competencies to address specific needs. Knowing that the holistic needs of the individual are being met by partner organizations allows for specialization and efficiency in delivery. Using existing assets and leveraging potential partnerships in delivery creates a more integrated system of care.

How do I start building a complex care ecosystem in my community?

Two National Center programs — regional complex care convenings and the Ecosystem Community Learning Collaborative — currently support local groups of stakeholders in starting and strengthening complex care ecosystems in their communities. 

Our regional convenings program selects an annual cohort of host organizations to convene groups of stakeholders around barriers to complex care in their communities. Get more information about how to apply to host a regional convening, and find lessons and publications from past host organizations.

The Ecosystem Community Learning Collaborative launched spring 2021 with multi-organization collaboratives from six communities across the country. Each ecosystem site receives technical assistance and coaching from the National Center, and also meets regularly as a group to learn from each other. Lessons from the ecosystem sites will be published after the wrap-up of the learning collaborative in September 2021.

More resources:

Beginning or building a complex care program?

The tools and resources in the Data & process improvement and Community mapping & collaboration sections of the Complex care startup toolkit will be most helpful in building an ecosystem if you already have a complex care program.

Hoping to build the business case for your complex care ecosystem or program? 

Use the value case summary tool in the Building the value case for complex care toolkit to demonstrate the return on investment (ROI) of your program or ecosystem. Also, you can apply lessons from our recent evaluation examining perceptions of value of cross-sector collaboration toward serving populations with complex health and social needs.

Training a complex care team or want to improve your skills and knowledge as a provider? 

The resources in the Integrated team collaboration and Systems complexity and context domains of our Implementing the core competencies: A toolkit to guide education and training are helpful for supporting a team in building a complex care ecosystem.