Abstract
A growing literature documents the substantial burden that a small proportion of high-cost, medically complex patients impose on health care systems. However, it is not clear whether high-cost patients remain costly over time. This study looks at the monthly distribution of billed charges for a cohort of high-cost, medically complex patients enrolled in an intensive care management program in a university health care system, and finds that the billing trajectory is heterogeneous and highly nonlinear, characterized by a substantial spike in billed charges prior to identification, followed by a considerable drop prior to enrollment and a sustained drop thereafter. The conclusion is that many high-cost patients experience costly events that resolve without intensive case management. These results also suggest that interventions should target only those high-cost patients with expected continued high cost and that pre-post study designs may overstate the impact of interventions for high-cost, medically complex patients.
Original language | English (US) |
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Pages (from-to) | 362-367 |
Number of pages | 6 |
Journal | Population Health Management |
Volume | 20 |
Issue number | 5 |
DOIs | |
State | Published - Oct 1 2017 |
Externally published | Yes |
Keywords
- care management
- cost of care
- economic impact
ASJC Scopus subject areas
- Leadership and Management
- Health Policy
- Public Health, Environmental and Occupational Health