CommunityHealth hosts the All In Chicago event each fall as a forum to discuss solutions for providing accessible health care for all Chicago residents. At the 2016 event, we brought together leaders from hospitals, pharmaceutical and insurance companies, non-profits, local government and community organizations to engage in a conversation about the importance of data and social determinants in providing whole-person care rooted in authentic healing relationships.
Our keynote speaker, Mark Humowiecki, spoke on behalf of the nationally recognized Camden Coalition of Healthcare Providers, a group that strives to improve the quality, accessibility, coordination, and efficiency of the healthcare system in Camden, NJ and throughout the country by focusing on fixing the system for high cost, high needs individuals.
Mark began the discussion by introducing the concept of healthcare hotspotting. Much of the U.S. health care costs are driven by a small number of individuals. Our system is designed to work for the average patient and struggles to help the small number of patients with complex needs and chronic conditions. These outliers are known as super-utilizers. Over time, their chronic conditions worsen, leading to even more expensive, invasive, and risky treatment. Super-utilizers are the patients our standard systems have failed.
The Camden Coalition’s hotspotting program uses data to discover the outliers and reallocate resources for effective interventions that include non-medical needs such as housing, mental health, and substance abuse. In his speech, Mark shared statistics that demonstrate the sharp cost curve of treating super-utilizers. On the extreme end of the cost curve, 1% of patients account for 30% of total health care costs, and 10% of patients account for 74% of costs. Through hotspotting, Camden, NJ hopes to become the first U.S. city to bend the cost curve while improving the quality of care.
The Camden Coalition is also having success with its Housing First program that began in 2015. Housing First is an evidence-based housing model that ends homelessness for individuals facing long-term housing challenges. The program identifies frequently-hospitalized and housing-unstable individuals in Camden, and provides them with safe, dignified housing with extensive support services so that they can improve their health and manage chronic conditions. Mark explained that lack of housing has been shown to drive up utilization of the ER, and by putting people into apartments quickly, the program cuts hospital costs, increases patient dignity, and improves medication adherence.
Mark also took time to speak about the 7-Day Pledge, a community initiative with a focus on accountable care. The 7-Day Pledge is a citywide campaign to ensure all hospitalized patients in Camden meet with their primary care provider within 7 days of discharge. Research shows that seeing a primary care doctor within 7 days is likely to prevent a return visit to the emergency room or hospital. These follow-up visits create confidence in family and caretakers as a patient embarks on the healing and recovery process, and connect patients to additional support services. The 7-Day Pledge is key to reducing preventable and ineffective health care spending. Money that would otherwise be invested in acute care, is redirected to more effective community health and wellness programs.
To continue the conversation on health care delivery reform, Mark has taken time to answer some of the leftover All In audience questions over at this LinkedIn post.
Next week’s blog will recap some of the topics discussed during the panel discussion at All In Chicago 2016.