The mantra for the last few years among many healthcare policymakers has been the need to focus on high-cost patients when looking at ways to slow healthcare costs. But in an article in the New England Journal of Medicine, the authors argue for taking a broader approach, especially for those in such relatively new payment models as Accountable Care Organizations.
J. Michael McWilliams, M.D., a professor of health policy and medicine at Harvard Medical School, and Aaron L. Schwartz, Ph.D., a health economist at Harvard, write that more care coordination is essential and say that because system-wide changes may have varying cost structures, focusing on a specific patient group might not be very effective in cutting overall system costs.
Among examples they give of areas for cost-cutting not involving a patient-group-centered approach, they suggest developing preferred networks of specialists or e-consulting systems that reduce unneeded referrals. They also said that providers could launch decision-support programs to cut the number 0f unneeded tests or prescriptions and improve triage to divert patients from emergency departments to outpatient clinics.
