Even the most trivial of emergency-room trips can quickly add up. Going in for an upper respiratory infection averages more than
$1,000. A urinary tract infection can set patients back thousands of dollars. But before Obamacare came on the scene, New Jersey physician Jeffrey Brenner was already working on innovative ways to slash health-care costs. He scoured health-care billing data at local hospitals and discovered that a small number of “super utilizers” clustered in certain geographic areas were responsible for the bulk of health-care costs in Camden, N.J. He brought together a team of social workers and medical professionals, who made regular house calls to those patients, accompanied them to doctor’s appointments and conducted long interviews with them to obtain health histories—all to help the city cut medical costs and provide better care to these neediest patients. That was some six years ago. His work, called health-care hot spotting, helped net him a MacArthur “genius” award in 2013.
Now he works full-time on this issue and oversees a team of about 20 nurses, social workers, community health-care workers, Americorps volunteers and a psychologist who attack this problem around Camden. More than 50 similar operations have popped up around the country, and Brenner assists half of them. The latest such health hot spotting project Brenner works with is Sutter Health, a huge system consisting of some 30 hospitals in northern California. Brenner, the executive director of the nonprofit Camden Coalition of Healthcare Providers, spoke with Scientific American about how to predict who will cost the health-care system the most, his plans for his “genius” prize winnings, and his latest efforts to study health hot spotting with a randomized controlled trial.
....Do you think this model of hot spotting is a good fit in both rural and urban areas?
Yes. We have worked with groups in Eureka, Calif., which is incredibly isolated, and found the same patterns hold up. We have also worked with a group in rural Maine, another in rural Michigan and also in rural Pennsylvania.
What we’re finding over and over with our partners across the country is that the number-one determinant of being a high utilizer of health care is the amount of adverse childhood experiences you had, like physical and sexual abuse. There is interesting literature to back that up. In short, those traumatic experiences in early childhood lead to lifelong health costs and can help predict health-care utilization rates.
To read the rest of this interview that Dina Fine Maron did with Dr. Brenner, go go: http://www.scientificamerican....h-health-care-costs/
Comments (1)