Two notable randomized controlled trials of complex care management programs released earlier this year are spurring valuable discussions across the complex care field. The studies — based on interventions at the Camden Coalition of Healthcare Providers and CareMore Health — reported very different results. Whereas the Camden Coalition found no impact on readmission rates at 180 days, CareMore reported favorable reductions in expenditures and utilization. While both organizations serve people covered by Medicaid, their patient populations and study inclusion criteria are very different. Analyzed in tandem, these studies provide an important opportunity to reflect on what the evidence is telling us and can inform efforts to improve care for individuals with complex health and social needs.
This webinar, coordinated by the Better Care Playbook and made possible through support from the Seven Foundation Collaborative, highlighted lessons from the two recent studies to help guide future program and measurement approaches for complex care management interventions. While both the CareMore Health and Camden Coalition programs focused on improving care for high-need, high-cost populations and addressing social drivers of health, the interventions varied in terms of population identification methods, enrollee characteristics, duration and staffing of the interventions, and measures used to evaluate effectiveness. Leaders from both programs explored implications for designing, implementing, and evaluating interventions that benefit specific subpopulations and shared details on their continuous improvement efforts to adapt their models and respond to challenges and setbacks. Their remarks addressed what else is needed, including more robust community partnerships and treatment and resource capacity, to truly meet a complex array of physical health, behavioral health, and social needs.
Invited payer and health system leaders reflected on the implications of these analyses for health care stakeholders interested in designing, implementing, and/or supporting interventions to improve care for high-need populations.
I. Welcome and Introduction
Speaker: Allison Hamblin, President and Chief Executive Officer, Center for Health Care Strategies (CHCS)
A. Hamblin welcomed participants and provided a brief overview of the evidence on complex care management programs for individuals with complex health and social needs, including a summary comparison of results from recent studies of Camden Coalition and CareMore Health.
II. Lessons from the Camden Coalition’s Complex Care Management Program
Speakers: Kelly Craig, MSW, Chief Strategy and Information Officer, and Aaron Truchil, MS, Director of Strategy & Analytics, Camden Coalition
K. Craig and A. Truchil described the Camden Core Model and addressed how it has been adapted based on evidence as well as ongoing improvement efforts. They also shared opportunities to leverage recent evidence to further improve the delivery of complex care and invest in cross-sector partnerships.
III. Lessons from CareMore Health’s Complex Care Management Program
Speakers: Farhad Modarai, DO, Associate Regional Medical Officer, and Brian W. Powers, MD, Director of Population Health Strategy and Analytics, CareMore Health
F. Modarai, DO and B. Powers, MD described CareMore Health’s complex care management program for a high-need, high-cost Medicaid population, including approaches to identifying the enrollees and employing community health workers. They also shared lessons for other health care stakeholders interested in leveraging recent evidence to inform complex care management programs.
IV. Implications for Health Care Stakeholders Investing in Complex Care
Reactors: Sara Kaplan-Levenson, MPH, MSW, Vice President of Complex Care, Maimonides Medical Center, and David Labby, MD, PhD, Health Strategy Advisor, Health Share of Oregon
S. Kaplan-Levenson and D. Labby reflected on implications of these two recent studies and lessons for the field, including how these results will inform ongoing efforts to refine how health system leaders, payers, and state and local policymakers design, implement, and support complex care interventions.