Total Risk

Not surprisingly, patients with the greatest needs are placing an inordinate burden on the healthcare system. According to the AHRQ, the top 5% of all patients account for 50% of total U.S. healthcare expenditures, and the costliest 1% of patients account for 21% of healthcare expenditures. Furthermore, treating people with chronic diseases accounts for 86% of our nation’s healthcare costs, where seven of the top ten leading causes of death are due to these chronic diseases.

Predictive analytics can go beyond traditional claims-based risk scores to accurately identify patients that are likely to incur high costs in the future. By flagging these potential high utilizers, healthcare organizations can focus on patients that could benefit most from earlier, more targeted interventions. Recognizing that a relatively small percentage of patients drive healthcare spending, better care coordination and management, along with sustainable cost-containment strategies, will lead to better outcomes and a reduction of overall healthcare costs.

21%

of all healthcare expenditures come from the top 1% costliest patients

86%

Treating people with chronic disease accounts for 86% of our nation's healthcare costs

7 of the 10

leading causes of death are due to chronic diseases

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