4.High-cost Patients Spark Cost-saving Innovations
It is no secret that a tiny sliver of the American patient population is responsible for consuming a sizable chunk of what the nation spends on healthcare. One of the most costly patient groups is the “dual eligibles” – the roughly 9.6 million who qualify for both Medicare and Medicaid. According to the report, in 2010, Medicare spent an average of $19,418 on each of these patients, compared to an average of $8,789 spent on other beneficiaries.
As a result, insurers, healthcare providers and others have been looking for innovative approaches to manage their sickest patients in a bid to manage costs in 2014. For instance, Spectrum Health System based in Grand Rapids, Michigan, identified 30 patients who frequented its emergency rooms and then offered them medical and case management interventions, such as finding primary care physicians within walking distance of their homes, the report said. This program ended up reducing emergency room visits by 90%, and the cost of treating these 30 patients fell to less than $130,000 from $1.1 million within a year.
Given how dual-eligibles cost a lot more to the system, more innovative cost management regimes with an eye toward better care coordination will continue in 2015.
