New Medicare and Medicaid Study Results from A.K. Jha et al Described (Concentration of High-Cost Patients in Hospitals and Markets)

Insurance Weekly News

By a News Reporter-Staff News Editor at Insurance Weekly News -- Current study results on Medicare and Medicaid have been published. According to news reporting from Boston, Massachusetts, by VerticalNews journalists, research stated, "Although we know that healthcare costs are concentrated among a small number of patients, we know much less about the concentration of these costs among providers or markets. This is important because it could help us to understand why some patients are higher-cost compared with others and enable us to develop interventions to reduce costs for these patients. Observational study."

The news correspondents obtained a quote from the research, "We used a 20% sample of Medicare fee-forservice claims data from 2011 and 2012, and defined high-cost patients as those in the top 10% of standardized costs. We then characterized high-concentration hospitals as those with the highest proportion of high-cost patient claims, and high-concentration markets as the Hospital Referral Regions (HRRs) with the highest proportion of high-cost patients. We compared the characteristics and outcomes of each. High-concentration hospitals had 69% of their inpatient Medicare claims from high-cost Medicare beneficiaries compared with 51% for the remaining 90% of hospitals. These hospitals were more likely to be for-profit and major teaching hospitals, located in urban settings, and have higher readmission rates. High-concentration HRRs had 13% high-cost patients compared with 9.5% for the remaining 90% of HRRs. These HRRs had a smaller supply of total physicians, a greater supply of cardiologists, higher rates of emergency department visits, and significantly higher expenditures on care in the last 6 months of life."

According to the news reporters, the research concluded: "High-cost beneficiaries are only modestly concentrated in specific hospitals and healthcare markets."

For more information on this research see: Concentration of High-Cost Patients in Hospitals and Markets. American Journal of Managed Care, 2017;23(4):233-238,66-68. American Journal of Managed Care can be contacted at: Managed Care & Healthcare Communications Llc, 666 Plainsboro Rd, Ste 300, Plainsboro, NJ 08536, USA.

Our news journalists report that additional information may be obtained by contacting A.K. Jha, Harvard TH Chan Sch Public Hlth, Dept. of Hlth Policy & Management, Boston, MA, United States. Additional authors for this research include K.E. Joynt, R. Wild and N.D. Beaulieu.

Keywords for this news article include: Boston, Massachusetts, United States, North and Central America, Medicare and Medicaid, Health Policy, Medicare, Hospital.