States Focus on "Super-Utilizers" to Reduce Medicaid Costs

Using a provision of the Affordable Care Act, many state Medicaid agencies are trying to diminish use of medical services by super-utilizers by better managing their care. The goal is to not only reduce costs, but to achieve better health outcomes for these patients.

In health policy circles, they are called “super-utilizers,” but the name isn’t meant to connote any special powers. Just the opposite.

They are people whose complex medical problems make them disproportionately heavy users of expensive healthcare services, particularly emergency room treatment and in-patient hospitalizations. The cost of treating them is huge: Just 5% of Medicaid’s 68 million beneficiaries account for 60% of the overall spending on the program.

Using a provision of the Affordable Care Act, many state Medicaid agencies are trying to diminish use of medical services by super-utilizers by better managing their care. The goal is to not only reduce costs, but to achieve better health outcomes for these patients.

Read more at the The Pew Charitable Trusts: http://bit.ly/12mXmcS