This special report from the National Academy of Medicine begins to separate the complex health and social needs population into segments such as people with multiple chronic conditions, non-elderly disabled, frail elderly, children with complex needs, and more. Evidence-backed complex care models are then matched to each sub-population. Read the report The National Academy of...

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This brief from Center for Health Care Strategies, Inc. (CHCS) is a practical guide to maximizing the value of community health workers on complex care teams. The brief covers recruitment, training, team integration, and support of this important role. Read the brief

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A review of the current state of the field of complex care from the Center for Health Care Strategies, Inc. (CHCS). This report identifies current gaps in knowledge, including segmentation, measuring quality outcomes, and aligning financial incentives across systems, and maps a path forward. Read the report here

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The Complex Care Map is a cross-continuum, EMR-based tool created by Lauran Hardin, Senior Director of Cross-Continuum Transformation for the National Center, when she was at Trinity Health-Michigan. The Complex Care Map equips providers with a comprehensive root-cause analysis for people with complex health and social needs in order to reduce fragmentation of care. A...

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