Delivering Care to High-Cost High-Need Patients: Lessons Learned in the Development of a Complex Care Primary Care Team
As part of a population health-focused primary care transformation, in 2019 a health system in Minnesota developed a primary care team to exclusively care for high-cost high-need patients. Through its development and implementation, the team has discovered several key lessons in delivering care to c...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
SAGE Publishing
2021-06-01
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| Series: | Journal of Primary Care & Community Health |
| Online Access: | https://doi.org/10.1177/21501327211023888 |
| _version_ | 1819069069687521280 |
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| author | Deborah L. Pestka Nicole L. Paterson Katarzyna A. Benedict Donovan D. Williams Beth A. Shellenbarger Allison J. McVay-Steer Tiffany Cheng Jennifer Pangburn Debra Warner Lisa Bryant |
| author_facet | Deborah L. Pestka Nicole L. Paterson Katarzyna A. Benedict Donovan D. Williams Beth A. Shellenbarger Allison J. McVay-Steer Tiffany Cheng Jennifer Pangburn Debra Warner Lisa Bryant |
| author_sort | Deborah L. Pestka |
| collection | DOAJ |
| description | As part of a population health-focused primary care transformation, in 2019 a health system in Minnesota developed a primary care team to exclusively care for high-cost high-need patients. Through its development and implementation, the team has discovered several key lessons in delivering care to complex patients. These lessons include the benefits of more integrative team-based care, the need and advantages of designated complex care team members, the importance of teamwork both within and outside of the complex care team, the need for frequent communication, and the importance of identifying mental health needs. In addition, there are several areas that require ongoing research and exploration, such as determining when a patient is able to graduate out of the program, how to enhance access to the complex care team, determining appropriate visit characteristics, and model feasibility. While addressing the needs of high cost high need patients is essential to improving quality of care and decreasing health care costs, there are several unique challenges and opportunities that come with caring for this patient population. Although this highly integrated model of care continues to evolve, the initial lessons learned may inform other health systems and care teams undertaking the care of complex patients. |
| first_indexed | 2024-12-21T16:44:11Z |
| format | Article |
| id | doaj.art-10b45d397e8643ffb7b474d4d5547a50 |
| institution | Directory Open Access Journal |
| issn | 2150-1327 |
| language | English |
| last_indexed | 2024-12-21T16:44:11Z |
| publishDate | 2021-06-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Journal of Primary Care & Community Health |
| spelling | doaj.art-10b45d397e8643ffb7b474d4d5547a502022-12-21T18:57:02ZengSAGE PublishingJournal of Primary Care & Community Health2150-13272021-06-011210.1177/21501327211023888Delivering Care to High-Cost High-Need Patients: Lessons Learned in the Development of a Complex Care Primary Care TeamDeborah L. Pestka0Nicole L. Paterson1Katarzyna A. Benedict2Donovan D. Williams3Beth A. Shellenbarger4Allison J. McVay-Steer5Tiffany Cheng6Jennifer Pangburn7Debra Warner8Lisa Bryant9University of Minnesota College of Pharmacy, Pharmaceutical Care and Health Systems, Minneapolis, MN, USAM Health Fairview, Eagan, MN, USAM Health Fairview, Eagan, MN, USAM Health Fairview, Eagan, MN, USAM Health Fairview, Eagan, MN, USAM Health Fairview, Eagan, MN, USAM Health Fairview, Eagan, MN, USAM Health Fairview, Eagan, MN, USAM Health Fairview, Eagan, MN, USAM Health Fairview, Eagan, MN, USAAs part of a population health-focused primary care transformation, in 2019 a health system in Minnesota developed a primary care team to exclusively care for high-cost high-need patients. Through its development and implementation, the team has discovered several key lessons in delivering care to complex patients. These lessons include the benefits of more integrative team-based care, the need and advantages of designated complex care team members, the importance of teamwork both within and outside of the complex care team, the need for frequent communication, and the importance of identifying mental health needs. In addition, there are several areas that require ongoing research and exploration, such as determining when a patient is able to graduate out of the program, how to enhance access to the complex care team, determining appropriate visit characteristics, and model feasibility. While addressing the needs of high cost high need patients is essential to improving quality of care and decreasing health care costs, there are several unique challenges and opportunities that come with caring for this patient population. Although this highly integrated model of care continues to evolve, the initial lessons learned may inform other health systems and care teams undertaking the care of complex patients.https://doi.org/10.1177/21501327211023888 |
| spellingShingle | Deborah L. Pestka Nicole L. Paterson Katarzyna A. Benedict Donovan D. Williams Beth A. Shellenbarger Allison J. McVay-Steer Tiffany Cheng Jennifer Pangburn Debra Warner Lisa Bryant Delivering Care to High-Cost High-Need Patients: Lessons Learned in the Development of a Complex Care Primary Care Team Journal of Primary Care & Community Health |
| title | Delivering Care to High-Cost High-Need Patients: Lessons Learned in the Development of a Complex Care Primary Care Team |
| title_full | Delivering Care to High-Cost High-Need Patients: Lessons Learned in the Development of a Complex Care Primary Care Team |
| title_fullStr | Delivering Care to High-Cost High-Need Patients: Lessons Learned in the Development of a Complex Care Primary Care Team |
| title_full_unstemmed | Delivering Care to High-Cost High-Need Patients: Lessons Learned in the Development of a Complex Care Primary Care Team |
| title_short | Delivering Care to High-Cost High-Need Patients: Lessons Learned in the Development of a Complex Care Primary Care Team |
| title_sort | delivering care to high cost high need patients lessons learned in the development of a complex care primary care team |
| url | https://doi.org/10.1177/21501327211023888 |
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