To Contain Costs, Some Hospitals Tackle Patients' Non-Medical Problems

Fernandopulle's Special Care Center in Atlantic City is another model of a medical home. It accepts a flat fee for these 1,200 patients. After 12 months, he has found that ED visits and hospital admissions have been reduced by more than 40%. Surgical procedures were cut by one-fourth, and the patients are healthier, Gawande wrote. Patients with high cholesterol had an average 50-point drop in their lipid levels.

Brenner, Fernandopulle and Gawande are on to something that is perhaps one of the most exciting concepts in healthcare today. It's no big surprise that medical institutions and emergency rooms are perhaps the least appropriate places for patients like these.

Call them what you will – boomerangs, frequent fliers, super-utilizers or repeat customers. Yes, these are patients who now have true emergencies, but ones that could, weeks, months or years before, have been prevented.