Annual Lecture: High need, high cost patients: A universal challenge

Dr David Blumenthal, President of the Commonwealth Fund, hosts 6th IGHI Annual Lecture.

The Institute of Global Health Innovation host their sixth annual lecture.

Imperial staff, students and guests were honoured to welcome Dr David Blumenthal to South Kensington last week to hear him present the Institute of Global Health Innovation’s (IGHI) sixth annual lecture, which was chaired by Imperial Vice-Provost for Research, Professor Nick Jennings. 

Dr Blumenthal, who is President of The Commonwealth Fund in the United States, drew on his experience in health policy and reform to talk about his views on the universal challenge of managing high-need, high-cost patients.  His talk addressed in particular why we need to be mindful about this population of patients, to decipher who they are, to think about what the possible solutions are to caring for them better, to combat some of the key obstacles and also outlined what he and his team at the Commonwealth Fund were currently doing to try to improve their overall care. 

Using data from the United States, Dr Blumenthal informed us that the sickest 5% of patients accounts for 50% of the overall healthcare spend in America whilst comparable data for England shows that the sickest 3% accounts for 45% of costs.  These are very costly patients indeed, highlighting one of the reasons we need to be concerned about this patient population for both industrialised and industrialising countries.    

“High-need, high-cost patients are a very important part of our lives and still have a lot to contribute to our societies”, said Dr Blumenthal.  “They are our family members, our aging parents, our siblings and our in-laws.  In the US, the average adult American spends about $4800 on healthcare per year, a very large amount by international standards.  If you have three chronic conditions, you are likely to spend 50% more.  If you have those three chronic conditions plus a functional limitation (a deficit in your ability to perform typical activities of daily living), you will spend more than 400% annually on healthcare than the average American.  So putting this into perspective, it is imperative that a successful and thriving health system must perform well for high-need, high-cost patients if it is to be successful in reaching its goals.  I feel that this is the most important priority for any healthcare organisation that is concerned about the cost of care or about quality and patient safety”. 

Dr Blumenthal went onto note that caring for this group of patients works at its best with targeted interventions towards those most likely to benefit, close coordination among care and team members, improving microsystems and macrosystems within health systems, strong health IT and the promotion of patient and caregiver engagement.   

“I was honoured to be welcomed by Lord Darzi and IGHI and to learn about the activities and current research of the Institute and Imperial” said Dr Blumenthal.  “Lord Darzi’s work as a scientist, surgeon and healthcare innovation propagator alongside the work of IGHI is widely appreciated in the US including by myself and my team at the Commonwealth Fund.  It was a pleasure to host the 2016 IGHI annual lecture and to offer my insights into improving care and safety for high-need, high-cost patients.” 

Professor the Lord Ara Darzi, Director of IGHI said “We were delighted to host Dr Blumenthal at Imperial and we would like to thank him for his insightful thoughts, suggestions and ideas on a problem that is facing us all globally – a universal challenge”. 

Watch the lecture in full above, read the Storify coverage of the event below and view the photos from the event here.