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States Focus on "Super-Utilizers" to Reduce Medicaid Costs
Using a provision of the Affordable Care Act, many state Medicaid agencies are trying to diminish use of medical services by super-utilizers by better managing their care. The goal is to not only reduce costs, but to achieve better health outcomes for these patients.
In health policy circles, they are called “super-utilizers,” but the name isn’t meant to connote any special powers. Just the opposite.
They are people whose complex medical problems make them disproportionately heavy users of expensive healthcare services, particularly emergency room treatment and in-patient hospitalizations. The cost of treating them is huge: Just 5% of Medicaid’s 68 million beneficiaries account for 60% of the overall spending on the program.
Using a provision of the Affordable Care Act, many state Medicaid agencies are trying to diminish use of medical services by super-utilizers by better managing their care. The goal is to not only reduce costs, but to achieve better health outcomes for these patients.
Read more at the The Pew Charitable Trusts: http://bit.ly/12mXmcS
Blister Packs May Help Solve Medication Adherence Challenges and Lower Health Care Costs
June 10th 2025Julia Lucaci, PharmD, MS, of Becton, Dickinson and Company, discusses the benefits of blister packaging for chronic medications, advocating for payer incentives to boost medication adherence and improve health outcomes.
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From Red Tape to Relief: Rewriting the Rules of Prior Authorization
June 23rd 2025Up to 257 million Americans could benefit from these prior authorization reforms that could have cross-market implications on health care plans administered through commercial insurers, Medicare Advantage, and Medicaid.
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