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Improving Care for High-Cost, High-Need Patients
Peggy Eastman. Oncology Times, 2016-09-29
Topic: Risk, prevention and care in population studies
And, she noted, data from the 2009-2011 Medical Expenditure Panel Survey have shown that “high-need adults spent more on health care but were less likely to report that the health system works for them.” Abrams said it is important to specifically target this population: assess their needs; develop effective care plans; engage patients and family members in managing their care; connect patients to follow-up and support services; coordinate care with all providers; and monitor patients' progress. Boling concluded that, in many cases, the best way to care for these low-income, high-needs patients is house calls. Boling, whose site is one of the IAH demonstration participants, said that according to data from the Centers for Medicare & Medicaid Services (CMS), IAH demonstration year one results (June 2015) showed savings of more than $25 million on 8,400 high-cost beneficiaries, for more than $3,000 saved per beneficiary. Asked how travel time to and from housebound patients can be cost-effective for physicians, he said, “The payment has to be worth their while.” Katherine Hayes, JD, Director of Health Policy for the Bipartisan Policy Center, agreed with Abrams that misaligned financial incentives are often a barrier to the sustainability and spread of successful models of care for high-needs, high-cost older patients. “While changing federal reimbursement policy is not the only solution, without change, financial incentives are a significant barrier to sustainability and spread of successful models,” she said.
Key findings
- And, she noted, data from the 2009-2011 Medical Expenditure Panel Survey have shown that “high-need adults spent more on health care but were less likely to report that the health system works for them.” Abrams said it is important to specifically target this population: assess their needs; develop effective care plans; engage patients and family members in managing their care; connect patients to follow-up and support services; coordinate care with all providers; and monitor patients' progress.
- Boling concluded that, in many cases, the best way to care for these low-income, high-needs patients is house calls.
- Boling, whose site is one of the IAH demonstration participants, said that according to data from the Centers for Medicare & Medicaid Services (CMS), IAH demonstration year one results (June 2015) showed savings of more than $25 million on 8,400 high-cost beneficiaries, for more than $3,000 saved per beneficiary.
- Asked how travel time to and from housebound patients can be cost-effective for physicians, he said, “The payment has to be worth their while.” Katherine Hayes, JD, Director of Health Policy for the Bipartisan Policy Center, agreed with Abrams that misaligned financial incentives are often a barrier to the sustainability and spread of successful models of care for high-needs, high-cost older patients. “While changing federal reimbursement policy is not the only solution, without change, financial incentives are a significant barrier to sustainability and spread of successful models,” she said.
Why it matters
This report describes care approaches for high-cost, high-need patients, including assessing needs, developing care plans, engaging patients and families, and coordinating care. It notes that a demonstration showed savings on high-cost beneficiaries, but that misaligned financial incentives are often a barrier to spreading successful care models.
Study details
- Evidence strengthLow
How this study scored 22/100
Published in a peer-reviewed journal. Scored zero for study design, sample size, effect reported, studied in people and randomised / blinded because the record does not state it. We have no data on institution's track record, so that was left out: it earned 21 of the 97 points we could judge it on, which is 22 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Oncology Times) |
| Journal's citation record | 0 / 4 | Oncology Times: journal h-index 24 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2016 — within 20 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 0 / 7 | Cited 0 times (OpenAlex, 2026-10-10) |
| Citations per year | 0 / 5 | 0.0 citations a year over 12 year(s) since 2016 |
| Impact for its field and year | 0 / 6 | Cited 0.0× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | 0 / 4 | Cited 0 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 1 / 4 | Last-listed author Peggy Eastman: h-index 5 (OpenAlex, whole career) |
| Institution's track record | — / 3 | No institution listed in OpenAlex — left out of this score |
| Multi-centre collaboration | 0 / 3 | OpenAlex lists 0 institution(s) in 0 countries — scores zero (affiliation lists can be incomplete) |
| Indexed in PubMed | 1 / 2 | Not in PubMed, but has a DOI |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Points | 21 / 97 | Scored on 19 of 20 parts. We have no data for the rest, so they are left out: 21 of the 97 points we could judge it on is 22 out of 100. |
| Total | 22 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
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Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. Check the citation against the original before you use it.
APA 7th
Eastman, P. (2016). Improving Care for High-Cost, High-Need Patients. Oncology Times. https://doi.org/10.1097/01.cot.0000503429.93604.60
Vancouver
Eastman P. Improving Care for High-Cost, High-Need Patients. Oncology Times. 2016. doi:10.1097/01.cot.0000503429.93604.60.
BibTeX
@article{eastman2016-738a4899,
author = {Eastman, Peggy},
title = {{Improving Care for High-Cost, High-Need Patients}},
journal = {Oncology Times},
year = {2016},
doi = {10.1097/01.cot.0000503429.93604.60},
url = {https://doi.org/10.1097/01.cot.0000503429.93604.60}
}
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