A patient holds a themometer, while a nurse takes his temperature.

Six organizations that operate quality improvement alliances in RWJF’s Aligning Forces for Quality (AF4Q) initiative strive to develop and implement effective models to meet the needs of super-utilizers outside the emergency room.

About This Series

In many regions across the country, robust “super-utilizer” programs that provide intensive outpatient care management to high-need, high-cost patients are beginning to emerge. The term “super-utilizer” describes individuals whose complex physical, behavioral, and social needs are not well met through the current fragmented health care system. As a result, these individuals often bounce from emergency department to emergency department, from inpatient admission to readmission or institutionalization—all costly, chaotic, and ineffective ways to provide care and improve patient outcomes. This collection explains Jeffrey Brenner's approach to improving health care delivery and illustrates how three organizations are testing and expanding this model.

Related Stories

thumbnail

A Revolutionary Approach to Improving Health Care Delivery

February 1, 2014 | Story

Jeffrey Brenner, MD, created a model for improving care while reducing costs for complex patients who are "superutilizers" of the health care system. After using claims data to identify these patients, teams offer personalized care management.

thumbnail

Cleveland Medical Center Aims to Improve Care for Super Utilizers

September 25, 2013 | Story

MetroHealth will provide more care to 150 patients with diabetes, hypertension, and heart failure for 18 months. Then it will compare the before and after costs.

thumbnail

Massachusetts Implements Program for Treating Chronic Conditions, Deceases ER Visits

September 25, 2013 | Story

In Massachusetts, a family health center seeks to cut ER usage by 30 percent, implementing a program to identify and care for those who are high-utilizers.

thumbnail

Treating Super Utilizers in Rural Pennsylvania

September 25, 2013 | Story

A private foundation in Pennsylvania invests in a nonprofit health system’s program to identify and treat super-utilizers.

See all