Quality of care for people with complex needs begins with a person-centered assessment and care planning process that addresses what is most important to the individual. Better integration can improve care for people with complex needs, but failure to rigorously measure quality could result in cost savings at the expense of quality.
People with complex needs—such as older adults with multiple chronic conditions and functional limitations as well as persons with physical, intellectual or developmental disabilities and/or severe and persistent mental illness—often require combinations of medical care, behavioral health care and long-term services and supports (LTSS). There is broad agreement that person-centered, goal-based, integrated care has the potential to improve health outcomes and reduce the cost of caring for people with complex needs.
Quality measurement in health care has long been used to drive improvement and provide accountability of the health care system to consumers and payers. However, quality measures assessing person-centered outcomes are lacking. Our case studies of nine sites shed light on opportunities and barriers to advance person-centered, goal-based care and outcome measurement. The aim of this policy brief is to present our case study findings and policy recommendations for developing the infrastructure necessary to deliver and measure person-centered, goalbased, integrated care to people with complex needs.