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Persistent high utilization in a privately insured population.

Wenke Hwang1, Michelle LaClair, Fabian Camacho

  • 1Penn State University College of Medicine, Department of Public Health Sciences, 90 Hope Dr, Ste 2200, Hershey, PA 17033.

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Persistent high healthcare users, representing 2.9% of enrollees, drove 21% of total spending. These individuals had higher disease burden and costs for medications and services, emphasizing the need for proactive chronic disease prevention.

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Area of Science:

  • Health Services Research
  • Healthcare Economics
  • Chronic Disease Management

Background:

  • Identifying individuals with consistently high healthcare utilization is crucial for understanding cost drivers.
  • Persistent high users represent a small but significant portion of healthcare expenditure.

Purpose of the Study:

  • To characterize individuals defined as persistent high users (top 10% of users for 3 consecutive years).
  • To analyze the healthcare expenditure, utilization patterns, and clinical conditions of persistent high users compared to other groups.

Main Methods:

  • Retrospective cohort study of privately insured individuals from 2009-2011.
  • Categorized enrollees into four groups based on consistent high-percentage spending over three years.
  • Utilized insurance claims data and 2008 baseline characteristics to analyze healthcare costs and conditions.

Main Results:

  • 2.9% of 42,038 enrollees were persistent high users, accounting for 21% of total healthcare expenditure.
  • Persistent high users exhibited a greater overall disease burden, primarily from multiple chronic conditions.
  • This group incurred significantly higher costs for medications and professional services, including primary and specialty care.

Conclusions:

  • Proactive engagement for primary and secondary prevention of chronic diseases is essential.
  • Early intervention can mitigate escalating healthcare utilization and costs for individuals.
  • Targeted strategies are needed to manage the health status of persistent high users.