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Viewpoint |

Optimizing High-Risk Care Management

Brian W. Powers, AB1,2; Sreekanth K. Chaguturu, MD1,2,3; Timothy G. Ferris, MD, MPH1,2,3
[+] Author Affiliations
1Harvard Medical School, Boston, Massachusetts
2Partners HealthCare, Boston, Massachusetts
3Massachusetts General Hospital, Boston, Massachusetts
JAMA. 2015;313(8):795-796. doi:10.1001/jama.2014.18171.
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This Viewpoint discusses the potential of high-risk care management programs that are practice-based, payer-catalyzed, and purchaser-supported to deliver better care at lower cost.

The most costly 1% of patients account for one-fifth of national health expenditures—accruing average annual expenses of nearly $90 000 per person.1 These individuals typically have several complex, co-occurring conditions for which they often receive poorly coordinated care, driving unnecessary utilization and poor outcomes. Given these characteristics, high-risk care management programs have potential to improve care and reduce costs for this population.2,3 The structure of these programs varies, but most involve care managers who work with panels of high-risk patients to coordinate care across clinicians, engage patients in setting and achieving health-related goals, and monitor and track health outcomes. Although these programs have traditionally been managed by payers or third-party vendors, clinicians and health care organizations are increasingly adopting programs of their own.2,4

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The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
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