Complex care takes a holistic approach to serving individuals experiencing complex health and social needs. While the field has existed for over a decade, many working in the space still struggle to succinctly and clearly articulate what exactly complex care is, whom it serves, what issues it strives to address, and what value it provides to individuals, communities, and institutions. Unlike health care fields that focus on specific parts of the body (e.g., cardiology), diseases (e.g., oncology), or specific populations (e.g., pediatrics), complex care means different things to different people. These communication challenges make it harder to engage patients and family members who could benefit from complex care services, build collaborative bridges with potential partners, and make the case for ongoing investment in the field to health system leaders, policymakers and funders.

In Pursuit of Clear and Consistent Language

With support from The SCAN Foundation and the Robert Wood Johnson Foundation, the Center for Health Care Strategies (CHCS) and the Camden Coalition’s National Center for Complex Health and Social Needs partnered in developing a messaging guide to help stakeholders communicate about complex care more clearly and consistently. To inform the guide, we released a survey completed by more than 100 stakeholders, and conducted six focus groups including patients, providers, policymakers and health care leaders. This stakeholder feedback helped us better understand the different ways complex care is described, communication pain points, and the types of messaging support that would be most useful.

Our new resource, Talking About Complex Care: A Guide for Clear and Effective Communications, contains:

  • Guidance for developing an effective message;
  • Suggested messaging, broken down by context and audience; and
  • An overview of terminology and person-first language.

The guide is designed to make it easier to communicate about complex care, and to strengthen the field by supporting consistency in the way it is talked about. This blog post highlights key challenges in communicating about complex care and associated communication tips included in the guide.

We Asked Stakeholders “How Do You Describe Complex Care?”

Our national survey aimed at patients, providers, policymakers and health care leaders posed this question. The below three disparate responses to describe the same thing highlight how inconsistent messaging can make it difficult for audiences to understand complex care.

  • Complex care works to stabilize an individual’s medical, behavioral health and social needs to the point where they can self-manage or have longitudinal supports in place to assist in self-management.
  • Treating the whole family not just the person with the complex needs.
  • Coordinating the support necessary to mitigate the risks and damages that a family encounters when coping with a serious illness.

Why Talking About Complex Care is Hard

The challenge of communicating about complex care stems from several factors, including:

  • The field is still coalescing around definitions. There is no single, agreed-upon meaning of what complex care is or who it serves;
  • The challenges complex care seeks to address are… complex. It is difficult to succinctly describe the various personal, social and environmental forces that contribute to an individual facing both complex health and social needs, and equally challenging to articulate why an individual’s social needs should be taken into consideration when addressing health care needs.
  • Complex care messaging needs to be tailored to the context and the audience. For example, a message that helps persuade a person to participate in a complex care program may not convince a policymaker of the field’s value. Understanding what language to use under which circumstances is critical.

Developing Your Message

In creating strong and consistent language related to complex care, core tenets of communication can help support more effective messaging, including:

  • Know your audience. Consider what matters most to them and tailor talking points to touch on their priorities.
  • Keep it short and sweet. Prioritize the most important pieces of your message and don’t make your points overly complicated or dense.
  • Be both literal and visceral. Combine facts and figures with personal stories and conceptual metaphors.

Keeping this guidance in mind, below are some sample complex care messages tailored to speak to the individual, community and systems levels that complex care impacts:

Complex care addresses…A lack of person-centered care: The existing health care system and workforce are not equipped to meet the needs and preferences of people dealing with multiple health challenges.
The drivers of health:
Current care delivery often focuses on patients’ immediate medical issues and fails to address the social and economic causes of poor health.
Complex care improves…Health and well-being: Complex care addresses challenges that interfere with a person’s ability to achieve optimal health, well-being, and quality of life.
Patient and provider satisfaction:
Complex care provides a better experience for individuals, families, and providers, including opportunities to co-design care approaches.
Complex care addresses…Rigid and fragmented care delivery systems: Our health and social systems (e.g., health care, public health, social care, housing, education, etc.) typically focus narrowly on a single need and are not designed to work together to address multiple needs.
High cost due to preventable utilization:
Lack of access to necessary physical, behavioral, and social services often results in poor health outcomes and avoidable, and often expensive, use of services.
Complex care improves…Access to quality care: Complex care helps patients get access to the right services at the right times from the right providers.
Cost and utilization:
Complex care improves services for a population that despite frequent, and often costly, use of health care and social services, still has poor health outcomes.
Complex care addresses…Systemic racism and implicit bias: Members of marginalized groups (e.g., people of color, people with disabilities) face racism, ableism, and other systemic forms of bias and oppression. These forces are also present within our health and social systems and impact the quality of care.
Chronic underfunding of essential systems:
For decades, the United States has under-resourced public health institutions, behavioral health services, and community-based organizations necessary for maintaining the health and well-being of populations and communities.
Complex care improves…Collaboration by reducing fragmentation: Complex care strengthens opportunities for collaboration –within the health care system and across sectors and the community — to better meet patient, provider and organizational needs.
Systems for all:
Complex care infuses a focus on person-centered and equitable care delivery into our health and social systems, and supports integrated care delivery to align with the needs of the individual.

What’s Next?

The language of complex care has evolved significantly over the past decade. Outdated terms such as “frequent flyers,” “super-utilizers,” and “hotspotting” used to be commonplace. We have fortunately become more attuned to ensuring that language is person-centered, and more sophisticated in describing the intersecting issues that complex care seeks to address. The language will no doubt continue to evolve, particularly if and as the field further coalesces around more refined definitions of what complex care is and who it serves through projects such as the PCORI-funded Developing a Patient-Centered Complex Care Research Agenda and as the evidence around promising approaches to improve care for people with complex needs grows.

We hope that this messaging guide provides a useful jumping off point for being able to more effectively speak about and make the case for complex care. We would be interested in hearing more about the communications challenges you’re facing and what additional supports this guide can provide to help address these needs. We welcome your insights and questions — please share your comments below.

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