Cutting Medicare spending requires more than disease management

An analysis showed the 10% of Medicare patients with the highest costs accounted for 33% and 79% of emergency department and hospitalization costs in 2009 and 2010, respectively. The study found the main causes of inpatient spending for these patients were catastrophic events such as sepsis, heart attack and stroke, plus cancer and orthopedic procedures such as hip replacement and spine surgery. Although improving outpatient chronic disease management is very important, it "may not be focused on the biggest and most expensive problems plaguing Medicare's high-cost patients," researchers wrote in the Journal of the American Medical Association.

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