Academic Medical Centers and High-Need, High-Cost Patients: A Call to Action.

Health care delivery systems, including academic medical centers (AMCs), are increasingly focused on improving care for vulnerable, high-need, high-cost patients, in part because value-based payment models offer the promise of financial returns, or the avoidance of losses, for doing so. AMCs and other providers that have participated in Medicare and Medicaid demonstrations and value-based payment programs have important insights to offer about the features of successful and promising programs for high-need, high-cost patients. As more AMCs embrace value-based payment, they may have greater flexibility to provide services that address the medical and nonmedical needs of clinically complex patients and thereby reduce avoidable health care utilization. AMCs have many opportunities to create high-performing health systems, establish operational evidence for how to transform delivery systems, and train the next generation of providers to better address the care of high-need, high-cost individuals.