Complex Care Management Is Key To Keeping Healthcare Costs Down


A disproportionate amount of medical costs comes from a small group of patients with complicated illnesses. According to Medical News Today, “it is generally accepted that 10 to 15 percent of Medicare patients account for 65 to 75 percent of all Medicare spending.”

Therefore, managing this group of patients efficiently is key to keeping healthcare costs down.

Many hospitals are implementing “complex care management - assembling multidisciplinary teams of physicians, nurses, pharmacists, mental health professionals and others, with services being coordinated by care managers who work closely with patients and their family members.”

Clemens Hong, the author of an article in the NEJM about this issue, states, “Not only can fully addressing the needs of complex care patients keep them healthier, but it also can reduce costs by avoiding emergency departments visits and unnecessary hospitalizations.”

The strategy of complex care management will be especially effective as insurance companies make their reimbursement dependent on the patient’s outcome and the quality of care they receive.

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