Managed Care

 

Super-Utilizers versus Non-Utilizers

Super-Utilizers versus Non-Utilizers

Steven Peskin, MD

Steven Peskin MDA recent conversation reminded me of the forgotten population in health care — the non-utilizers. I was speaking with a physician leader in Lancaster, Pa., about his program that emulates the good work of Dr. Jeff Brenner and his team in Camden, N.J., that has targeted the 1 percent of patients responsible for 30 percent of the cost. In similar fashion, the program in Lancaster targets 10 percent of the population that account for 50 percent of the cost. Dr. Atul Gawande's New Yorker article this past January drew attention to this important work and to several other super-utilizer programs. http://www.newyorker.com/online/blogs/newsdesk/2011/01/atul-gawande-super-utilizers.html The physician from Lancaster then commented, But what about the 50 percent of our population that uses only three percent of health care resources? In that cohort there will likely be a few of next year's super-utilizers. I am not advocating medicalization of healthy people. However, surveillance, risk identification and stratification, early warning systems, and investment in continued health and well-being of today's non-utilizers may defuse a few ticking time bombs and advance a culture of health versus a system of sickness care and super-utilizers. Steven R. Peskin, MD, MBA, FACP
Executive Vice President and Chief Medical Officer
of MediMedia, USA, which publishes Managed Care

Meetings

2014 Annual HEDIS® and Star Ratings Symposium Nashville, TN November 3–4, 2014
PCMH & Shared Savings ACO Leadership Summit Nashville, TN November 3–4, 2014
Medicare Risk Adjustment, Revenue Management, & Star Ratings Fort Lauderdale, FL November 12–14, 2014
World Orphan Drug Congress Europe 2014 Brussels, Belgium November 12–14, 2014
Healthcare Chief Medical Officer Forum Alexandria, VA November 13–14, 2014
Home Care Leadership Summit Atlanta, GA November 17–18, 2014
6th Semi-Annual Diagnostic Coverage and Reimbursement Conference Boston December 4–5, 2014
Customer Analytics & Engagement in Health Insurance Chicago December 4–5, 2014
Pharmaceutical and Biotech Clinical Quality Assurance Conference Alexandria, VA December 4–5, 2014
9th Semi-Annual Medical Device Coverage and Reimbursement Conference San Diego December 5, 2014
8th Annual Medical Device Clinical Trials Conference Chicago December 8–9, 2014
HealthIMPACT Southeast Tampa, FL January 23, 2015