Medicaid directors are continually faced with difficult decisions regarding how best to spend limited public dollars. Improving care for the program’s most chronically ill and costliest beneficiaries may be one of the most effective, and sustainable, ways for states to both advance the quality of care and bend cost trends in publicly financed care.

One of the five promising reform strategies outlined in CHCS’ policy brief, Medicaid Best Buys: Promising Reform Strategies for Governors, was to improve care management for high-need, high-cost beneficiaries with multiple chronic conditions. This new brief outlines important steps for states to consider in designing comprehensive programs for this complex need population. It also highlights three states that are pioneering new care management approaches.

This report is part of CHCS’ Medicaid Best Buys series developed to help states, health plans, and policymakers identify programs that have the greatest potential to improve health care quality and control costs for high-risk beneficiaries. The series, supported by the Robert Wood Johnson Foundation, provides policy recommendations and technical resources to guide program development and implementation.