In this study, high-need patients are defined as those aged 65 and older with at least three chronic conditions or a functional limitation in activities of daily living. The brief analyses data from the Commonwealth Fund 2014 International Health Policy Survey of Older Adults to investigate health care use, quality, and experiences among high-need patients in nine countries (Australia, Canada, France, Germany, the Netherlands, Norway, Sweden, Switzerland, and the United States) compared with other older adults. The study found that high-need adults use more health care – especially avoidable Emergency Department visits –, experience more cost-related barriers to care, and poorly coordinated care. Given that high-need adults consume a much greater proportion of health services than other adults – for example, five percent of the U.S. adult population accounts for 50 percent of the nation’s health care costs – the brief suggests that the comparative success of some countries, particularly in reducing financial barriers to care, may be a product of policies that specifically target high-need patients.