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High-Cost Patients

High-cost patients are a continuing problem for Health Care. The top 5% of claimants usually account for more than 50% of the total health care cost of the population.

For a health plan, controlling the costs of high cost patients is often a primary goal. The first step is identifying who these patients are and understanding why they are high-cost. Is it a one-time illness? Is it an accident? Is it a collection of co-morbid conditions? Is it event or age related? Is it a catastrophic illness or some other cause?