CBC Solutions is a service organization that addresses the needs of complex care patients. We typically contract with a payer and/or at-risk entity (e.g., insurer, health system, managed care organization, or health foundation) to support improved service delivery for the cohort of difficult-to-manage and/or high-cost clients (“high utilizers”). These high utilizers are typically identified by one or more of the following criteria:

  • Frequency of ED visits or hospitalizations over a period of time;
  • Top 1-2 percent of the cost of members within a community; and/or,
  • Identified by a community resource as a high utilizer of their services.

High utilizers account for 18 percent of ED visits nationwide, at an annual cost of $11.2 billion. This group also has hospitalizations that last 60 percent longer than the general public, and they have a mortality rate three times higher than the general public.

Most high utilizers of our health care system have unique medical conditions, often impacted by social circumstances, such as homelessness, substance use disorders, and behavioral health issues, making them resistant to typical care coordination services. While most have some sort of assigned care coordination, standard telephonic or off-site care coordination practices tend to fail with this group. The unique circumstances surrounding these individuals make them best served by staff available within the community, familiar with their unique needs, and who have an intimate knowledge of community resources.

Our Innovative Approach & Best Practices

CBC Solutions successfully helps payers and providers improve health outcomes and control costs among high utilizers by staying focused on a few core priorities:

  • We find and engage clients where they are.
  • We coordinate with existing community resources.
  • We provide 24/7/365 availability to clients.

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