Atul Gawande’s refers to them in his New Yorker piece as The Hot Spotters. Just as law enforcement in community policing identifies crime. Can we lower medical costs by giving the neediest patients better care? If Camden, New Jersey, becomes the first American community to. New Yorker. Jan The hot spotters: can we lower medical costs by giving the neediest patients better care? Gawande A. PMID: ; [Indexed .

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A Critical Look at Healthcare Delivery Reform” unpacks the data behind healthcare delivery system interventions, highlighting well-intended reforms that have yet to achieve the impact many have assumed.

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The coordinators also focused their efforts ghe hospital-to-home care transitions and medication management. Chemistry has the periodic table, physics has Newtonian equations, biology has the theory of evolution. Its model utilizes “care teams” made up of health professionals with expertise in such disciplines as nursing, pharmacy, health coaching, counseling, social work, and community health work.

Cancer Patients and Social Media. Wed, Jul 10th, Having heard Clay Christensen expound on disruptive These people averaged 62 hospital and E. If Camden, New Jersey, becomes the first American community to lower its medical costs, it will have a murder to thank. Fri, Jun 21st, Nobel peace prize winner Muhammad Yunus is no It would be hard to say it better. Link to full text in the New Yorkert: According to a report published in the Journal of the American Medical Associationpatients assigned to the control group improved just about aatul much as those receiving the intensive services.

Yet it is clear these efforts are falling short of expectations, and much more work — and rigorous evaluation — will be needed to deliver on the promise of better, more efficient care for this population. But when independent researchers conducted a pre-planned evaluation of the program in which they compared enrolled patients with similar controls, the data told a different story.

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The hot spotters: can we lower medical costs by giving the neediest patients better care?

Recent efforts by the Camden Coalition and other similar-minded innovators have inspired a much-needed renewed focus on the most complex patients in our healthcare system. A neighborhood couple, a physical therapist and a volunteer firefighter, approached to see if they could help, but police waved them back. After an initial intake visit, the team contacts enrolled patients at a minimum of twice monthly.


The best I can do for now is summarize the article and encourage you to either purchase the issue or read it online at a later date. By providing follow-up consultation and care to such patients before they might otherwise seek further in-hospital care, “hot-spotting” aims not only to cut healthcare costs associated with repeated hospitalizations, but ultimately to improve the health of those most in need. Another example of a successful complex care management effort was a program for high-risk older adults in Pennsylvania led by an organization called Health Quality Partners as part of the same Medicare demonstration described above.

Brenner’s group defines healthcare hot-spotting as “the strategic use of data to reallocate resources to a small subset of high-needs, high-cost patients. The tenets teh regression to the mean dictate that if a variable is extreme on its first measurement, it will, on its own, tend to be closer to the average on its spoters measurement.

The most recent was about hospice care. Very few of these programs have reached the level [of ths I would consider convincing,” he said. But spottres a mainstream doctor to say that proactive patient centered care spptters money and is worthwhile is, I think, monumental.

The hot spotters: can we lower medical costs by giving the neediest patients better care?

To their credit, the Camden Coalition has acknowledged that the dramatic data initially reported about their program may be overblown. And he does it so well….

In response to Camden’s initial purported success, healthcare systems around the nation scrambled to develop similar approaches of their own. Your email address will not be published. It turns out that we easily can be tricked by simple analyses of programs targeting high-risk populations because of a well-established — but counter-intuitive — statistical principle known as regression to the mean. Boeing funded a specialized intensive outpatient clinic for these employees with a dedicated physician and nurse care manager, who oversaw the care of to high-risk patients.

Links to all articles in the series are available on the Gehr Center and Updates in Slow Medicine websites. We don’t understand what drives some patients to over-utilize healthcare services and others to under-utilize care.

This second article in the series explains why targeted programs for high needs, high cost patient populations may not be achieving their intended goals. He created a way to find the people whose use of medical care was highest, and go after them and provide better care. What do we have in complex care? The study concluded that, relative to controls, “these programs had favorable effects on none of the adherence measures and only a few of many quality of care indicators examined,” and did not favorably impact the costs of care.


The controlled analysis of this program, unlike most of the others in the demonstration, showed not only reductions in avoidable emergency room and hospital visits but also reduced mortality among those enrolled.

While emergency room visits, hospitalizations, and overall costs among enrolled patients may have dropped substantially, there is no telling whether patients would have experienced these same improvements even without the program.

One of the doctors that works for Verisk, Nathan Gunn, who explains the way data mining can be used to identify the most frequent users of health-care facilities and reduce their costs. Click here slotters read the rest of the New Yorker article. Can we lower medical costs by giving the neediest patients better care? The ideal study design for evaluating hot-spotting approaches, says Asch, is a randomized control trial.

These kinds of cost savings are revolutionary.

At nine-fifty on a February night ina twenty-two-year-old black man was shot while driving his Ford Taurus station wagon through a neighborhood on the edge of the Rutgers University campus. But upon closer inspection, careful analysis of the Camden program and others like it raises concerns that these apparent jaw-dropping improvements may be overstated. A pile of meaningless terms and poorly tested ideas. One that did was the Medicare Care Coordination demonstrationa program in which 15 healthcare organizations from around the country were given the opportunity to develop programs for improving care coordination among the most complex populations.

As a result, many “super-users” of hospital facilities today are likely to stop being high-volume users in the future, regardless of whether they receive intensive targeted services — often referred to as “complex care management” — or not. A Vision of Connected Health: