• Leah M Marcotte, Ashok Reddy, and Joshua Liao.
• Department of Medicine , University of Washington School of Medicine, Seattle, WA, USA. leahmar@uw.edu.
• J Gen Intern Med. 2019 Nov 1; 34 (11): 2634-2636.

AbstractOne increasingly popular strategy for addressing avoidable healthcare costs is to couple "hotspotting" with interventions that deliver expanded, more intense primary care services to high-cost patient populations. While there is rationale for such intensive primary care programs, early results have been lackluster. Geoffrey Rose's preventive medicine strategy provides insight about a potential explanation: that the narrow scope of these initiatives on small groups of high-cost patients may inherently prevent them from achieving overall cost reductions across entire patient populations. While additional work and results from innovative non-healthcare-based interventions are needed, healthcare organizations may benefit from instead investing in broader interventions that impact patients across cost levels, including average- or low-cost patients.

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