This article is more than 5 years old. Information may no longer be current.
Study: Most spending for high-cost Medicare patients not preventable through better care
Click Here to Manage Email Alerts
Researchers of a study recently published in the Journal of the American Medical Association found that a small percentage of costs for acute care and emergency department visits associated with high-cost Medicare patients are preventable, suggesting that offering better outpatient care may have limited impact on lowering these costs.
“A large portion of spending for high-cost patients is likely not preventable through outpatient care management. Thus, we also need to think about how to redesign inpatient care to reduce spending per episode if we hope to effectively bend the cost curve,” Karen E. Joynt, MD, MPH, from Brigham and Women’s Hospital in Boston and the Departments of Health Policy and Management at the Harvard School of Public Health, told Orthopedics Today. “Orthopedic care was a big source of spending in our project, and orthopedic surgeons likely have an important role to play in thinking through how to redesign care to be less expensive without sacrificing quality.”
Karen E. Joynt
According to a Harvard School of Public Health press release, Joynt and colleagues analyzed Medicare files from 2009 and 2010 and included 1,114,469 Medicare patients aged 65 years and older in their study. They defined those in the top decile of spending in 2010 as high-cost patients. The top 10% of patients in the high-cost group accounted for 32.9% of emergency department costs and nearly 80% of inpatient costs. The researchers found 42.6% of emergency department visits by this group were preventable and 41% of emergency department costs were linked with these visits.
|
|
“The biggest drivers of inpatient spending for high-cost patients were catastrophic events, such as sepsis, stroke and myocardial infarction, as well as cancer and expensive orthopedic procedures such as spine surgery and hip replacement. These findings suggest that strategies focused on enhanced outpatient management of chronic disease, while clinically important, may not be focused on the biggest and most expensive problems plaguing Medicare’s high-cost patients,” the researchers wrote in their study.
References:
Joynt KE. JAMA. 2013;doi:10.1001/jama.2013.7103.
www.hsph.harvard.edu
Disclosure: This study was funded by the Rx Foundation and the West Wireless Foundation.