HKS Authors

See citation below for complete author information.

Daniel Paul Professor of the Practice of Government and Technology, HKS and FAS


“Complex patients” have clinically advanced illness and multiple co-morbid disease states. They are among the most expensive cases in healthcare. “Patient-centered management” is an emerging comprehensive patient-focused collaboration that includes end-of-life and pain management, education, provider coordination, and patient advocacy. It emphasizes the selection and coordination of services from the patient’s perspective and considers all of the patient’s circumstances. Managed care organizations seem best positioned to use patient-centered management with complex patients and healthcare providers, but the economic benefits of patient-centered management are not clear. Today, many managed care organizations concentrate on “case management,” which includes the identification and coordination of plan benefits and ancillary services. Case management tends to focus on services while patient-centered management focuses on the broader context of the patient. The key question addressed in this study is whether patient-centered management can reduce utilization costs in complex patients over case management without sacrificing life span.


Sweeney, Latanya, Andrew Halpert, and Joan Waranoff. "Managing End-of-Life Care in Complex Patients Can Reduce Costs Without Shortening Life." American Journal of Managed Care (February 2007): 84-92.