Fact: 1 percent of US patients account for 28 percent of healthcare spending

…and five percent is responsible for more than half of all spending.

According to the Agency for Healthcare Quality and Research (AHRQ), the US spent about $6,280 per person on health care in 2004. That adds up to around $1.9 trillion, which accounts for about 16 percent of our nation’s GDP. To put this into context:

• In 1980, costs were about $1,106 per person, or $255 billion total.
• This represents far and away the most per person in any country in the world:

So what’s the good news? While there are certainly plenty of policy opportunities to bring down health care spending through tighter regulation and more efficient care delivery, the focused distribution of spending might hint at another opportunity to bring down costs.

As discussed recently in Health Affairs, if we know there is a small group of people taking up a big slice of the pie, then we ought to be “hotspotting” those groups of patients and designing interventions that address what’s really going on. The authors point to a joint effort between the Aetna Foundation and Brookings Institute to launch a technology platform that helps connect high-cost, high-risk citizens to an array of clinical and non-clinical resources, including social services and community-based agencies.

Yet as we’re seeing in urban public health campaigns across the country, the highest-risk patients, such as those with unmet sociobehavioral needs, or the most complex, frail, and elderly of our society, require care that is extremely intensive, individualized, and often, relationship-driven.

To wit, solving the data problem is necessary but not sufficient, to solve the people problem. And that makes sense: addressing our problem of expensive people won’t fix health care spending on its own, but its a good a place to start as any.