The Real World Benefits of the Complex Care Model
At NHHA, all work is done with a simple philosophy in mind: collaboration, sharing resources, integrating healthcare, and using creative thinking. The connection of these elements can help solve equity issues and increase the quality of life of vulnerable populations. We have seen it work in creating solutions to problems – from big cities to the most rural and under-resourced communities.
The U.S. has one of the highest rates of healthcare spending in the world. Vulnerable populations are only 5% of the population, but account for almost 50% of all healthcare spending. To alleviate this impact, it is important to understand people's stories and foster collaboration across sectors. This is where the complex care model comes into play.
The complex care model relies on collaboration between health systems, policymakers, community partners and individuals to meet the needs of vulnerable populations. The goal is to decrease the complexity of an individual case and take it down to a solvable size so that people receive holistic care and aren’t falling through the cracks of the healthcare system. For example, take a 35 year old with Schizophrenia. He has had bouts of psychosis that have led him to getting arrested. This criminal record renders him unable to get a job, and as a result, he loses his access to stable housing. The key to understanding how to create a better life for him is to see him as someone with a story whose chapters are all interconnected.
We are all affected by the need for complex care, and this begs the question: how can healthcare advisors link, integrate, and create systems that provide health and healing? The simplest thing those in the healthcare industry can do is listen to their patients' stories. Healthcare providers are trained to ask and listen to their patients medical needs, but don't always ask about other needs that affect their health, like housing, transportation, and access to medicine.
Linking systems in a complex care model may sound expensive, but we cannot afford NOT to use it as a solution. With healthcare accounting for 18% of the American GDP, it is too much to spend on a crisis we are not putting money towards solving. If we release 50% of costs in the healthcare industry, those are a lot of resources we could use elsewhere. As seen in one example, after they adopted a complex care model, their ROI was 23%, and unnecessary hospital visits were cut 43%.
Healthcare data analytics is a powerful tool, and it can be used to prevent problems before they become big. Data shows us new and innovative patterns that are difficult to observe naturally. There are also some really exciting ways of using AI and NLP (natural language processing) to look for patterns in data that aren't easily accessible. This helps spot instances before they become big problems—making it easier to address quickly and efficiently before they snowball.
The community at large looks at shared data across systems and looks at who's vulnerable in their community—who might need help or resources in order to avoid homelessness or the risk of homelessness—and then acts on that information. They take the lessons they learned from those individuals and translate them into changes and other efforts aimed at preventing homelessness from occurring in the first place.
We can see the need for the complex care model’s success because it will create new ways to meet the needs of vulnerable seniors and those living with disabilities, while also making the current systems more efficient and responsive to the needs of their communities.
