Super-Utilizers versus Non-Utilizers
A recent conversation reminded me of the forgotten population in health care — the non-utilizers. I was speaking with a physician leader in Lancaster, Pa., about his program that emulates the good work of Dr. Jeff Brenner and his team in Camden, N.J., that has targeted the 1 percent of patients responsible for 30 percent of the cost. In similar fashion, the program in Lancaster targets 10 percent of the population that account for 50 percent of the cost. Dr. Atul Gawande's New Yorker article this past January drew attention to this important work and to several other super-utilizer programs.
The physician from Lancaster then commented, But what about the 50 percent of our population that uses only three percent of health care resources? In that cohort there will likely be a few of next year's super-utilizers. I am not advocating medicalization of healthy people. However, surveillance, risk identification and stratification, early warning systems, and investment in continued health and well-being of today's non-utilizers may defuse a few ticking time bombs and advance a culture of health versus a system of sickness care and super-utilizers.
Steven R. Peskin, MD, MBA, FACP
Executive Vice President and Chief Medical Officer
of MediMedia, USA, which publishes Managed Care