‘Hotspotting’ Study Stirs Debate About Social Determinants with Chart: Health Care ‘Hotspotting’ Program Shows Little Effect on Medically Complex Patients

In the health care industry, it’s become almost dogma that a small number of “superutilizers” — typically patients with complex medical and social challenges — are driving a disproportionate share of costs in the system. But a newly published study suggests that efforts to improve care and lower costs associated with those individuals aren’t always as effective as they’re heralded to be. And some think that should serve as a gut check for how organizations like health insurers think about social determinants of health.

The subject of the study in question is the Camden Coalition of Healthcare Providers, which convened health systems, primary care officers, community organizations and other stakeholders in a bid to test whether short-term, intensive care management would help reduce the cost of caring for some of the hardest-to-treat patients after they’re discharged from the hospital.

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Leslie Small

Leslie Small

Leslie has been working in journalism since 2009 and reporting on the health care industry since 2014. She has covered the many ups and downs of the Affordable Care Act exchanges, the failed health insurer mega-mergers, and hundreds of other storylines spanning subjects such as Medicaid managed care, Medicare Advantage, employer-sponsored insurance, and prescription drug coverage. As the managing editor of Health Plan Weekly and Radar on Drug Benefits, she writes and edits for both publications while overseeing a small team of reporters who also focus on the managed care sector. Before joining AIS Health, she was a senior editor for the e-newsletter Fierce Health Payer, and she started her career as a copy editor at multiple local newspapers. She graduated with a dual degree in journalism and political science from Penn State University.

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