The Need

One of healthcare’s greatest unmet needs is designing and delivering care that truly meets the requirements of people with complex needs.


Because the need is so great, and the impact of solutions so far-reaching, CACP chooses to dedicate itself to transforming care for individuals with complex health and social needs. 


How do we define complex needs? To start, complexity results from the convergence of many health determinants:


Medical Factors


  • Multiple chronic conditions

  • Physical disabilities

  • Frailty

  • End of life

Behavioral Factors


  • Severe mental illness

  • Chronic depression
    and anxiety

  • Developmental disabilities

  • Cognitive impairment

  • Substance use disorder

Social Factors

  • Food insecurity

  • Housing insecurity

  • Low health literacy

  • Low self-esteem

  • Social isolation

  • Socio-economic status

  • Stigma

  • Trauma

And what is the impact of complexity? An article published by The Commonwealth Fund in 2016 contrasted two groups: individuals with three chronic health conditions, and individuals with three chronic conditions plus functional limitations (limitations in their ability to care for themselves or perform routine daily tasks). The differences were dramatic. Compared with individuals with multiple chronic conditions only, people with complex needs:


     • Averaged more than triple the healthcare expenditures

     • Averaged more than double the rate of hospital use


In dollar terms, the dimensions of the problem are enormous. We know, for example, that adults with complex needs average more than $21,000 per year in health care and prescription drug costs – more than quadruple the average for all U.S. adults. And the top 5% of this group averaged over $73,000 in annual healthcare spending.*



* Hayes, S. et al. High-Need, High-Cost Patients. Who Are They and How Do They Use Healthcare?: The Commonwealth Fund




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