Health Affairs

Health Affairs, 26, no. 6 (2007): 1643-1654 doi: 10.1377/hlthaff.26.6.1643 © 2007 by Project HOPE	New Online   Getting Health Reform Done   After the State of the Union   Incremental Reform   E-Health in Developing World   Most-Read Articles in 2009

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Medicaid

Improving The Management Of Care For High-Cost Medicaid Patients

John Billings and Tod Mijanovich

Increased policy attention is being focused on the management of high-cost cases in Medicaid. In this paper we present an algorithm that identifies patients at high risk of future hospitalizations and offer a business-case analysis with a range of assumptions about the rate of reduction in future hospitalization and the cost of the intervention. The characteristics of the patients identified by the algorithm are described, and the implications of these findings for policymakers, payers, and providers interested in responding more effectively to the needs of these patients are discussed, including the challenges likely to be encountered in implementing an intervention initiative.

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