01 Jul Health Care Transformation Task Force Unveils Roadmap to Identify High Cost Patients

New White Paper Intended to Inform the Work of Health Care Systems & Payers Across the Country in Providing Better Care at Lower Costs

WASHINGTON, D.C. – The Health Care Transformation Task Force, a consortium of patients, payers, providers and purchasers working to transform the U.S. health care system, today released a white paper on best practices for identifying costly patients with complex needs who might benefit from targeted care management, ultimately improving care and reducing total costs for the entire health care system.

The paper – “Proactively Identifying the High Cost Population” – addresses the issue that 5 percent of the patients are responsible for 50 percent of health care spending. While providers and payers know this problem exists, many find it challenging to successfully identify these patients and appropriately tailor care delivery for them. Experts from the Task Force’s High Cost Patient Work Group, composed of Task Force members and partner organizations, wrote the paper based on the experience of members and a survey of the relevant literature to help providers and payers across the country pinpoint these patients.

The paper defines three different types of high cost patients – patients with advanced illness, often near the end of life; patients with persistent high spending patterns; and patients with episodic high spending – and presents methods for identifying patients in the first two categories. It also reviews quantitative and qualitative methods for stratifying these patients into care management programs, offering suggested tools and highlighting common errors.

The white paper is the first in a series of three papers to be developed by the Task Force’s High Cost Patient Work Group. Upcoming papers will share best practices in care management for high cost patients and guidelines to develop payer-provider relationships that promote sustainability of proven innovations.

In addition to the High Cost Patient Work Group, the Task Force’s other Work Groups focus on improving the design and implementation of the Accountable Care Organization (ACO) model and developing a common bundled payment framework.

The Task Force includes six of the nation’s top 15 health systems and four of the top 25 health insurers.  A full list of Task Force members – all committed to putting 75 percent of their business into value-based arrangements that focus on the Triple Aim of better health, better care and lower costs by 2020 – can be found at www.hcttf.org. 

About Health Care Transformation Task Force

Health Care Transformation Task Force is a unique collaboration of patients, payers, providers and purchasers working to lead a sweeping transformation of the health care system. By transitioning to value-based models that support the Triple Aim of better health, better care and lower costs, the Task Force is committed to accelerating the transformation to value in health care. To learn more, visit www.hcttf.org.