Complex care brings together professions, organizations, and sectors to center care around the needs, goals, and circumstances of the individual. But how can we tell if programs providing complex care are truly making a difference for their participants? Widely used metrics like cost and utilization do not reflect whole-person outcomes, and there is a stark lack of standardization among existing health and well-being metrics.

For the field of complex care to show its value in improving outcomes and to evaluate programs’ delivery and impact, evaluation and quality improvement measures must be identified and standardized.

The impetus for standard quality measures for complex care comes from the Blueprint for Complex Care (Blueprint), released in late 2018 by the National Center, the Center for Health Care Strategies (CHCS), and the Institute for Healthcare Improvement (IHI). The Blueprint assessed the state of the then-emerging field of complex care and provided 11 recommendations to strengthen and advance the field.

One of the Blueprint’s recommendations was to develop standard quality measures for complex care programs beyond cost and utilization. In response to this recommendation from the Blueprint, the National Center commissioned IHI to conduct a landscape analysis,interviews with subject matter experts, and a scan of existing quality measurement efforts pertaining to the field of complex care.

This brief is based on IHI’s final report, Measuring complexity: Moving toward standard quality measures for the field of complex care. The report:

• Documents the current state of quality measurement in complex care;
• Identifies key challenges associated with complex care; and
• Details current complex care research and measurement development efforts.

This brief summarizes the findings from the report, categorized in four areas — defining the population, data availability and potential sources, measurement domains, and measures and measure concepts — along with eight recommendations for next steps the field can take to develop a standard set of quality measures.