Denver Health Medical Center researchers report that its super-utilizer population — patients who use a large share of healthcare resources due to multiple chronic conditions and risk factors — changes over time.
An analysis of 4,774 publicly insured or uninsured Denver Health super-utilizers found at any time, 3 percent of them accounted for 30 percent of the organization's healthcare costs. However, only a small group of these patients demonstrate high usage for more than one year. Approximately 25 percent of them have high usage for relatively short durations of time.
"The study, which was funded by a grant from the Center for Medicare and Medicaid Innovation, identified clinically important subgroups among super-utilizers that may respond to different approaches to reduce avoidable healthcare use," Tracy Johnson, PhD, director of health reform initiatives at Denver Health and principal investigator of the study, said in a statement. "We have used these in-depth analyses of Denver Health patients who have experienced multiple hospitalizations to implement unique population health services tailored to their specific health and social risk profiles. This includes establishing a new primary care clinic that exclusively serves medically complex adults as well as adding new staff to follow up on hospitalizations and help support on-going care needs. This enhanced care team includes nurse care coordinators, clinical pharmacists, behavioral health consultants, social workers and patient navigators."