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Population Health Hot-Spotting

 |  By Jim Molpus  
   May 15, 2015

Leaders at Intermountain Healthcare have committed resources in analytics, care management, and clinic models to reduce high utilization.

This article first appeared in the May 2015 issue of HealthLeaders magazine.

Theorists in healthcare have tried over the years to apply some version of the Pareto principle to the health of a population. While Pareto's theory was that 80% of the land in Italy was controlled by 20% of its population, healthcare leaders believe that when applying the principle to population health, the real number of patients who use a disproportionate share of resources is less than 5%.

The term hot-spotters was popularized in a 2011 New Yorker article by Atul Gawande, MD, who profiled the work of Jeffrey Brenner, MD, a family physician in Camden, New Jersey, who found that just 1% of patients in the community accounted for 30% of healthcare costs. Scott Pingree, director of strategic planning at Salt Lake City–based Intermountain Healthcare, and other leaders at the integrated delivery system wondered whether their patient population was any different.

Intermountain Healthcare found that between 2008 and 2012, its top 5% of high-cost, high-utilizing patients consumed 51% of healthcare costs. Even more telling, the top 1%—the true hot-spotters—accounted for a starkly disproportionate share: 24% of all healthcare costs.

Jim Molpus is the director of the HealthLeaders Exchange.

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