Healthcare Hotspotting update: Intermediate Care Coordination Improved

Healthcare hotspotting describes the practice of finding geographic areas or patient groups that drive healthcare spending, and then addressing the clinical and social needs of these complex patients to improve their wellbeing and lower healthcare costs at the same time.  After all, about one-third of all healthcare spending is concentrated among 1% of patients; improving their care is a “big idea” in the re-design of healthcare in the US. 

The original randomized controlled trial research study, coauthored by Joe Doyle and published in 2019, found that the Camden Coalition Care Management Program did not reduce hospital readmissions. However, a 2023 update that used additional Medicaid data on post-discharge ambulatory care, found that the program  increased ambulatory visits by 15 percentage points (from 19 to 34% on average) after fourteen days postdischarge, driven by an increase in primary care. These effects persisted through 365 days. These results suggest that care coordination alone may be insufficient to reduce readmissions for patients with high rates of hospital admissions and medically and socially complex conditions.

For more, see:

1. The Camden Coalition Care Management Program Improved Intermediate Care Coordination: A Randomized Controlled Trial, by Amy Finkelstein, Joel C. Cantor, Jesse Gubb, Margaret Koller, Aaron Truchil, Ruohua Annetta Zhou, and Joseph Doyle Health Affairs, Dec 20, 2023

2. “Health Care Hotspotting — A Randomized, Controlled Trial" Amy Finkelstein, Ph.D., Annetta Zhou, Ph.D., Sarah Taubman, Sc.D., and Joseph Doyle, Ph.D.  New England Journal of Medicine, January 9, 2020