A class of patients known as “super-utilizers” makes up about 50% of health care spending, according to a recent Kaiser Health News report.
These are patients with complex health conditions that frequent emergency rooms even though they would be better treated by primary care doctors – which they often lack. But a program in Houston based on pioneering work done in Camden, New Jersey, pairs social workers with super-utilizers to help them receive health care and, in doing so, lower industry costs.
In Camden, the first group of patients to be treated saw ER visits drop by 40%, which cut health costs by about half, from $1.2 million to $500,000. That convinced Dr. Jeffrey Brenner, the Camden program’s pioneer, to expand the program to places like Houston. In Houston, health care costs for super-utilizers have fallen by 83%, and hospital visits by 70%, since implementation.
While successful, the program has faced opposition from some health providers, who are reluctant of losing revenue. Dr. Brenner believes there is a strong need for new approaches to managing population health, and that it will not be a short fight:
In America, we’re medicalizing social problems and we’re criminalizing social problems, and we’re wasting huge amounts of public resources. We have the wrong tools to solve the wrong problem. I think we’re in a 20-year arc of recalibrating and rethinking what is health and what’s health care? What’s the purpose of our health care system? What are we trying to accomplish?