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Better Care is the Key to Super-Utilizer Costs

Rene Letourneau, for HealthLeaders Media, March 4, 2013

Financial executives at hospitals and health systems know how desperately their organizations need to reduce the cost of care going to "frequent fliers." In the United States, 5% of the population uses 60% of the healthcare resources, mainly through the overuse of emergency room visits and inpatient hospital stays, according to the Robert Wood Johnson Foundation. Much of this care could be delivered in less expensive settings and some of it could be avoided entirely through better provider coordination and outpatient follow-up.

For Jeffrey Brenner, MD, current treatment protocols of super-utilizers, as he calls this group, are vastly inadequate both clinically and financially.

Brenner is the founder and executive director of the Camden Coalition of Healthcare Providers and the medical director for the Urban Health Institute at Cooper Hospital, both in Camden, NJ, one of the poorest communities in the country. Since starting out as a family physician in a solo practice in Camden over a decade ago, Brenner has become increasingly focused on patients who use a disproportionately high amount of hospital and ER services.

"Everywhere I have looked, I see the same basic rule of thumb ... a small portion of the population is driving all the [healthcare] costs. It's a basic law of human systems that a small number of people drive many of the problems," Brenner said during a recent speech at the Maine Hospital Association's annual conference.

Brenner noted that the top reasons for ER visits among super-utilizers include basic, non-acute issues: head colds, ear infections, sore throats, headaches, and other non-emergent health concerns. "We are occupying emergency rooms with things that don't need it," he said. "It's a cash cow. It's the best thing in the world for ER docs."

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