The results of a nationwide survey of patients with complex medical needs released December 9 by The Commonwealth Fund, shows that the healthcare system is failing them.

The results of the survey are bleak. It reveals that of those patients with a complex medical history:

• Nearly half (47 percent) visited the emergency department multiple times in the past two years.
• A majority did not have good access to services that could help them manage their conditions, such as adequate help with activities of daily living (62 percent) or an informed and up-to-date care coordinator (58 percent).
• Almost two-thirds (62 percent) experienced stress about their ability to afford housing, utilities, or nutritious meals.This compares to just 32 percent of people without high needs.
• A majority (59 percent) worried about being a burden to family and friends.
• More than one-third (37 percent) felt lonely, left out, or isolated from others.

"Our research shows that when people with complex needs require medical help, they encounter a healthcare system that's expensive, inefficient and poorly coordinated," said David Blumenthal, MD, president of The Commonwealth Fund. "We want to better understand what works for effectively treating these patients, so we can identify gaps, reduce duplication and accelerate what works."

While nearly all of the high-need patients surveyed have consistent access to health care (95 percent), they still struggle to get the coordinated medical, behavioral, and social services they need to stay well and avoid costly hospital visits. They had limited access to care coordinators, help with managing functional limitations, emotional counseling, and transportation services.

To counter the difficulties the survey uncovered, five foundations – the John A. Hartford Foundation, the Peterson Center on Healthcare, the Robert Wood Johnson Foundation, The SCAN Foundation and The Commonwealth Fund – have launched an online resource to help health system leaders and insurers boost care for patients with complex medical and social needs.

The Playbook: Better Care for People with Complex Needs, developed by experts at the Institute for Healthcare Improvement, compiles and shares promising approaches. It offers insights about patients with complex needs, examples of successful approaches to care, guidance on making the business case for these models, and opportunities for policy and payment reform.

The foundations releasing the Playbook will continue working both collaboratively and individually to spread promising care models, promote policy action, improve quality measurement and monitoring, and engage more stakeholders in better care for patients with complex needs.

Twitter: @Bernie_HITN
Email the writer: bernie.monegain@himssmedia.com

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