Atul Gawande’s refers to them in his New Yorker piece as The Hot Spotters. Just as law enforcement in community policing identifies crime. Can we lower medical costs by giving the neediest patients better care? If Camden, New Jersey, becomes the first American community to. New Yorker. Jan The hot spotters: can we lower medical costs by giving the neediest patients better care? Gawande A. PMID: ; [Indexed .

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And he does it so well…. The patients were also markedly healthier. But upon closer inspection, careful analysis of the Camden program and others like it raises concerns that these apparent jaw-dropping improvements may be overstated. The paradigm — referred to spotteers “hot-spotting” — has sprung up in dozens of places in the U.

You may use these HTML tags and attributes: With our background gawabde naturopathy, much of what Gawande describes seems so obvious, kind of preaching to the choir. Links to all articles in the series are available on the Gehr Center and Updates in Slow Medicine websites.

Wed, Jul 10th, Having heard Clay Christensen expound on aul Very few of these programs have reached the level [of success] I would consider convincing,” he said.

The most recent was about hospice care. The best I stul do for now is summarize the article and encourage you to either hit the issue or read it online at a later date. Many of the other rigorous studies of “hot-spotter” approaches have come to similar disappointing conclusions. Click here to read the rest of the New Yorker article. Without rigorous research to determine the exact impact of such programs, practitioners and patients alike cannot assume that complex care management is the primary reason for any improvement of such high-use patients, says Steven Asch, MD, professor of medicine at Stanford University and an expert in the field.


The hot spotters: can we lower medical costs by giving the neediest patients better care?

These people averaged 62 hospital and E. Another example of a successful complex care management effort was a program for high-risk older adults in Pennsylvania led by an organization called Health Quality Partners as part of the same Medicare demonstration described above. A Critical Look at Healthcare Delivery Reform” unpacks the data behind healthcare delivery system interventions, highlighting well-intended reforms that have yet to achieve the impact many have assumed.

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The hot spotters: can we lower medical costs by giving the neediest patients better care?

Yet it is clear these efforts are falling short of expectations, and much more work — and rigorous evaluation — will be needed to deliver on the promise of better, more efficient care for this population. But when independent researchers conducted a pre-planned evaluation tye the program in which they compared enrolled patients with similar controls, the data told a different story.

With this in mind, the dramatic results reported about programs like the Camden Coalition seem much less impressive. For example, a program could be piloted in one clinic and compared with a nearby similar control clinic. A neighborhood couple, a physical therapist and a volunteer firefighter, approached to see if they could help, but police waved them back.

He created a way to find the people whose use of medical care was highest, and go after them and provide better care. Brenner’s program, the Camden Coalitionis widely considered the prototype for the country’s growing number of programs for high-need and high-cost populations.


This second article in the series explains why targeted programs for high needs, high cost patient populations may not be achieving their intended goals. You can listen to the interview at: While it is too early to report data or to draw conclusions from that study, these results should provide insights about the program’s true impact.

Brenner’s group defines healthcare hot-spotting as “the strategic use of data to reallocate resources to a small subset of high-needs, high-cost patients. Joel Greenberg has been a science journalist for four decades.

The Hot Spotters by Atul Gawande |

At nine-fifty on a February night ina twenty-two-year-old black man was shot while driving his Ford Taurus station wagon through a neighborhood on the edge of the Rutgers University campus. Its model utilizes “care teams” made up of health professionals with expertise in such disciplines as nursing, pharmacy, health coaching, counseling, social work, and community health work. When Jeffrey Brenner, MD, took notice more than a decade ago of the spotty care afforded certain high-risk, high-need patients in Camden, N.

This entry was posted in News. By stulhis team had provided care for more than three hundred of these most costly people. The coordinators also focused their efforts on hospital-to-home care gadande and medication management.