Intensive management of patients at high-risk for hospitalization increases use of outpatient care but does not increase overall costs. While the costs associated with caring for these patients were not reduced, researchers found that the costs shifted from inpatient to outpatient services. Findings from the Department of Veterans Affairs study are published in Annals of Internal Medicine.
Primary care models that offer comprehensive, accessible care to all patients may not have sufficient resources to meet the needs of patients with complex chronic conditions, or the “sickest of the sick.” These patients often need more intensive services, such as psychosocial care. To address their needs, many health systems are piloting intensive management models that include interdisciplinary teams, care coordination, and support for care transitions. It is believed that these interventions may reduce hospitalizations and emergency department visits if they are implemented early when patients are first identified as high-risk. However, it is not known whether augmenting primary care would actually lower utilization and costs for these high-risk patients.
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