Targeting enhanced services toward high-cost, high-need medicare patients

Melissa Dattalo, Stephanie Nothelle, Elizabeth N. Chapman

Research output: Chapter in Book/Report/Conference proceedingChapter


High-cost, high-need patients account for disproportionate health-care costs. In the Medicare population, 5 % of fee-for-service beneficiaries account for 39 % of total Medicare spending. There are many inpatient, outpatient, and community-based services that can meet the complex needs of high-cost, high-need Medicare patients. Twenty-first-century health-care reform offers new opportunities to translate evidence-based models of care for complex patients into practice. New care delivery mechanisms such as Accountable Care Organizations and Home-Based Primary Care can improve quality of care and reduce costs. New incentives, such as hospital readmission penalties and outpatient reimbursement for care coordination, can also help traditional health-care delivery systems to enhance services for high-cost, high-need Medicare patients.

Original languageEnglish (US)
Title of host publicationNew Directions in Geriatric Medicine
Subtitle of host publicationConcepts, Trends, and Evidence-Based Practice
PublisherSpringer International Publishing
Number of pages18
ISBN (Electronic)9783319281377
ISBN (Print)9783319281353
StatePublished - Jan 1 2016


  • Affordable Care Act
  • Care management
  • Geriatric models of care
  • Health-care reform
  • High-cost
  • High-need patients
  • Hot spotting
  • Medicare
  • Readmissions
  • Transitional care
  • Utilization

ASJC Scopus subject areas

  • Medicine(all)


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