Expensive Medicare patients aren't who you think Print
Written by Peter Ubel, MD | KevinMD   
Wednesday, 23 October 2019 18:12

Over half of Medicare spending is concentrated in 10 percent of patients. With Medicare expenditures rising at an unsustainable clip, reigning in the costs of those patients is key to controlling health care spending. So who are those patients and what expenses are they racking up? It's not who or what I expected. When I think of high-cost patients, I envision people with drawn-out hospital stays, or imagine people readmitted to the hospital time and time again for chronic problems. Hospital care is expensive, meaning most of the most expensive patients in any given year have probably experienced a hospital stay or two. Or at least that's what I used to think. But when José Figueroa and colleagues at Harvard looked at Medicare expenditures, they discovered that chronically costly patients didn't become costly because of expensive hospital stays. Instead, it is outpatient expenses that stand out among these patients, including many very high-priced medications. The researchers were focused on identifying patients that weren't only expensive this year, say, but also next year and the next. Chronically expensive patients.