Coordinating Care for Adults With Complex Care Needs in the Patient-Centered Medical Home: Challenges and Solutions

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Coordinating Care for Adults With Complex Care Needs in the Patient-Centered Medical Home: Challenges and Solutions January 2012

AHRQ Publication No. 12-0010

Prepared For: Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services, 540 Gaither Road, Rockville, MD 20850, www.ahrq.gov

Prepared by: Mathematica Policy Research Princeton NJ

Authors: Eugene Rich, Mathematica Policy Research; Debra Lipson, Mathematica Policy Research; Jenna Libersky, Mathematica Policy Research; Michael Parchman, Agency for Healthcare Research and Quality.


Suggested Citation

Rich E, Lipson D, Libersky J, Parchman M. Coordinating Care for Adults With Complex Care Needs in the Patient-Centered Medical Home: Challenges and Solutions. White Paper (Prepared by Mathematica Policy Research under Contract No. HHSA290200900019I/HHSA29032005T). AHRQ Publication No. 12-0010-EF.Rockville, MD: Agency for Healthcare Research and Quality. January 2012. back to top


Abstract

Patients who have complex health needs require both medical and social services and support from a wide variety of providers and caregivers, and the patient-centered medical home (PCMH) offers a promising model for providing comprehensive, coordinated care. Smaller practices, however, face particular challenges in coordinating care for these patients. This paper explores the current landscape of PCMH services for patients with complex needs, details five programs that have addressed the challenges of caring for these patients, and offers programmatic and policy changes that can help smaller practices better deliver services to all patients, including those with the most complex health needs.

رابط[عدل]

https://pcmh.ahrq.gov/page/coordinating-care-adults-complex-care-needs-patient-centered-medical-home-challenges-and