Reducing costs may take more than focusing on high-cost patients
While a large chunk of healthcare spending may be concentrated among a small population of high-cost patients, focusing on those patients in order to cut down on wasteful spending may not work.
As J. Michael McWilliams, MD, PhD, and Aaron L. Schwartz, PhD, of Harvard Medical wrote in JAMA, hospitals and health systems in the age of value-based care may miss the bulk of spending on unnecessary services. The strategy may really be a holdover from fee-for-service incentives, because “targeting specific patients suits existing provider structures.”
“Targeting patients with high spending may not effectively target the spending that should be reduced,” McWilliams and Schwartz wrote. “Longitudinal patient-specific investments that are important for coordinating care and improving quality may be less important for curbing wasteful spending. And potentially more effective system changes that reduce wasteful care for all patients have different cost structures that may not require patient targeting to maximize savings.”
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John joined TriMed in 2016, focusing on healthcare policy and regulation. After graduating from Columbia College Chicago, he worked at FM News Chicago and Rivet News Radio, and worked on the state government and politics beat for the Illinois Radio Network. Outside of work, you may find him adding to his never-ending graphic novel collection.