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A 12-Month Collaborative

​​This Collaborative ended in June 2016. 

To see upcoming programs related to this topic, please visit our Education page.


In the US, 5 percent of the patient population generally represents 50 percent of total cost across all payers. This is also true outside of the US — health care organizations throughout the world recognize that a small percentage of the population generates a disproportionately large portion of health care costs.

This segment of the population is complex and dynamic. These individuals may struggle with one or more of the following: chronic physical and mental illness, poverty, and social isolation. They make frequent use of the health care system and often have poor outcomes. Their care can be chaotic, wasteful, and stressful for both patients and health care staff. The standard care system is not working for this segment of the population. The urgency to improve care for these patients is only growing as we strive to improve care continuity, patient centeredness, and reduce overall costs.

To accelerate the improvement of care for complex and high-cost patients, the Institute for Healthcare Improvement (IHI) invites you to join the Better Health and Lower Costs for Patients with Complex Needs Collaborative (BHLC), beginning July 2015. This initiative will help you plan and implement comprehensive care designs that serve the needs of your most complex, high-risk, and costly patients, resulting in better health outcomes, a better care experience, and lower total cost. Whether your organization has already established a program or is just starting this work, our goal is to help you make a positive and sustainable difference for this population.​​​​​​​​​

The Collaborative will be structured into two tracks — organizations can customize their work into one track or participate in both.
Foundations of Care Redesign: The focus of this track will be on moving through a well-tested process to design services and impact outcomes and costs for individuals with complex needs within each organization’s unique context. Through a robust, iterative learning process, teams will study their complex population, test interventions to change high utilization, and improve outcomes by developing a care model to deliver necessary services.
Scale-up and Sustainability: This track will be focused on expanding existing care models so they are equipped to serve additional individuals who need enhanced care, until all individuals who need care are reached. A focus on deep and iterative learning to ensure operational and financial sustainability and a continued impact on outcomes and costs will drive this track. This track is intended for organizations that have a care model in place and some degree of confidence that the model will improve outcomes at lower costs for their target population.
download_button.jpgDownload the 2015-2016 program prospectus to learn more about each of these tracks.

Who should participate?

Organizations that provide (or plan to provide) care for defined population groups while bearing the financial risk of caring for those groups will benefit from participation in this Collaborative. Typically, participants are health systems, but community organizations working to improve the welfare of a geographically defined population will also benefit. Participants may include the following:
  • Integrated systems of health delivery and financing operating anywhere in the world
  • Accountable Care Organizations (ACOs) or integrated delivery systems that are pursuing other new payment models
  • Physician group ACOs
  • Private or public employers seeking better health and value for employees
  • Privately- or publicly-funded health plans committed to improving value
  • Organizations embarking on innovative, population-focused designs
  • Safety net health care systems facing rising demand and flat budgets
  • Regional coalitions collaborating on a community-wide health issue or working to ensure access for all while controlling costs
  • Public health departments or social agencies focused on populations with complex health issues
  • Primary care or multi-specialty physician groups interested in risk sharing and cost savings arrangements

Review the list of confirmed participants here. Faculty are available to discuss whether this program is for you. Contact us today>>