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ACO Fall 2016

Hotspotting: Care Intervention for the Most Complex, Costly Patients

The Camden Coalition of Healthcare Providers utilizes hotspotting to identify the most complex and costly patients and enrolls them in a care management program to empower them to take control of their own healthcare.
During the first day of the ACO & Emerging Healthcare Delivery Coalition, speakers from the Camden Coalition of Healthcare Providers outlined an intervention that works with the 1% most complex and costly patients in Camden, NJ.

Renee Murray, associate clinical director of Care Management Initiatives at Camden Coalition, and Andrew Katz, senior program manager of Care Management Initiatives at Camden Coalition, began with a patient profile: George, who was diagnosed with schizophrenia, newly diagnosed with diabetes, had a cognitive delay, and minimal social support and interaction. He lands in the hospital 24 days a year, which reduces his quality of life, and during his most recent hospital admission, a team from the Camden Coalition met him at the bedside to develop a relationship and begin to help him meet his health goals.

Camden Coalition utilizes hotspotting, which segments patients on complexity, rather than disease type.

"In the traditional paradigm, we will often segment patients based on the conditions they have,"

 
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