Analysis: How to significantly reduce avoidable expenditures in Medicare

Nearly three-quarters of preventable Medicare spending in 2012 can be attributed to high-cost patients, according to a study supported by the Commonwealth Fund.

The study found 4.8 percent of Medicare spending in 2012 was preventable, and 73.8 percent of that preventable spending could be traced back to high-cost patients. High-cost frail, elderly patients — who make up 4 percent of the entire Medicare population — accounted for 43.9 percent of preventable Medicare spending in 2012. The average patient in this demographic sought unnecessary treatment totaling $6,593 in 2012, according to the study. They primarily sought care related to heart failure, pneumonia, urinary tract infections, diabetes complications and dehydration.

"Our work suggests that simple interventions in the outpatient setting, such as close management of heart failure and prevention of urinary tract infections, may substantially reduce unnecessary spending," the authors wrote.

The study was based on a sample of 2012 Medicare claims and an analysis of the avoidable emergency room visits and costs of care provided within 30 days of hospitalization.


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