What is complex care?

Complex care is care that is designed to meet the needs of individuals affected by hard-to-manage health and social conditions.

A small number of individuals drive much of the cost of health care in the United States. Although we spend a tremendous amount on these individuals—many of whom have a combination of chronic illness, behavioral health conditions, and multiple social needs—it has not made them healthy or well.

To make real changes for these patients, we must deliver care differently. Care must be flexible, coordinated, and centered on individuals’ needs, goals, and circumstances. This requires an interdisciplinary approach that brings together traditionally siloed areas.

Who are individuals with complex health and social needs?

No single definition encompasses all individuals with complex health and social needs, but many have several chronic and comorbid diagnoses and face social barriers to care including isolation, homelessness, lack of transportation, and unsafe living conditions. These individuals tend to experience poor outcomes despite substantial emergency care or inpatient services. Read more about individuals with complex health and social needs.

What is the National Center for Complex Health and Social Needs?

The National Center for Complex Health and Social Needs, launched in 2016, aims to improve outcomes for individuals with complex medical, behavioral, and social needs. It works to coalesce a new field of health care by bringing together a broad range of clinicians, researchers, policymakers, and consumers who are developing, testing, and scaling new models of team-based, integrated care. The Center and its staff collaborate with other experts across the nation to develop best practices, inform policy, and foster an engaged and accessible community to develop this work and teach it to others.

Who funds the National Center for Complex Health and Social Needs?

The National Center is funded by the Atlantic Philanthropies, the Robert Wood Johnson Foundation, and AARP. The National Center is an initiative of the Camden Coalition of Healthcare Providers.

Are there resources for health care professionals who treat individuals with complex health and social needs?

The National Center recently launched complex.care, an easy-to-use, web-based educational companion for clinicians, administrators, social service providers, and caregivers who support consumers, clients, or family members with complex health and social needs.

How is information about treating people with complex health and social needs being shared with students training in the health care workforce?

The Interprofessional Student Hotspotting Learning Collaborative is a program held annually that trains interdisciplinary teams of professional students from schools around the country to learn to work with complex medical and social needs using a person-centered approach. The program is intended to educate and provide mentorship for the next generation of health care professionals.

How will the movement toward payment and delivery reforms in the United States health care system affect individuals with complex health and social needs?

The U.S. health care system is shifting the way providers and hospitals are compensated for care, with an increased focus placed on quality and outcomes. This new way of paying for care will put more focus on achieving good outcomes for individuals with complex health and social needs by incentivizing collaborative approaches to caring for these consumers, including addressing their social needs.