“If we are in any way at risk for the costs of their health care, the people we serve fall roughly into four categories:
- “Healthy people whom we would like to keep healthy, to keep them out of the more expensive categories.
- “People with undiscovered illnesses or risk factors that we would like to discover and treat, to keep them from migrating up the cost scale.
- “People with multiple chronic illnesses or major risk factors. These people likely are already in that top 5 percent or are apt to jump into it. We would hope to migrate them down the cost scale through some serious attention and careful medical management.
- “People with serious illness such as cancer, or major trauma. They are — and should be — in the top 5 percent.”
Mr. Flowers suggests costs can be contained by “a multi-pronged prevention strategy based on market segmentation, which I often call ‘targeting.”‘
This strategy would include:
* Encouraging healthy communities.
* Providing screening.
* Targeting high-risk groups.
* Building trust and direct human connection into targeted programs.
* Targeting people with multiple chronic diseases.
* Building strong primary-care relationships.
* Changing practice and referral patterns.
