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Complex Care

When health care is fragmented, patients suffer and costs go up. People are healthier — physically and mentally — when their care is coordinated and their full needs are met.

Health care in the U.S. is broken and disjointed — and nowhere is that more apparent than among a population of individuals who have some of the most significant care needs in the country. About 12 million people in the U.S. are covered by both Medicare and Medicaid. These so-called “dual eligible” individuals account for a disproportionately high share of government health spending and often experience poor health outcomes.

Medicare and Medicaid are two different programs that cover different services and are operated by different arms of the government. Separate rules, processes, providers, and benefits make the system difficult to navigate. Our aim is to increase coordination of care for dual-eligible beneficiaries by promoting evidence-based models that provide seamless and integrated care across the continuum of services, including acute care, long-term support services, home care, behavioral health and social services needs. We back the development of state and federal policies that can improve this coordination.

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Complex Care Grants

$4,360,808

4X
Rate of average annual health care expenditures for people with disabilities or complex health compared with all U.S. adults
28%
Proportion of U.S. adults who have three or more chronic conditions
5%
Proportion of health care spenders who account for 51 percent of national health expenditures
2X
Rate of mental illness among the homeless as compared to the general population

Stories

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Complex Care The Pandemic is Going to Squeeze State Budgets. Here’s How Medicaid Programs Can Respond. Q&A

Grants

Arnold Ventures funds projects to understand problems and identify policy solutions.

Map of the U.S. made of Arnold Ventures icons