Revisiting the Super Utilizer

Donald Meade, 52, at his apartment in Fullerton, Calif., on February 13, 2016. Meade, a recipient of the Illumination Foundation’s housing-first program, has battled addiction, cancer and chronic heart problems that fueled recurring visits to the emergency room. (Heidi de Marco/KHN)

You know those people who make up 90% of the patients that go to the ER?  They are called frequent flyers by the staff but are called “super utilizers” for the euphemistically challenged.  Anyway, here is what I recommended to fix this issue three years ago in this blog :

  • Buying a small building or park a nice trailer next to the ER.
  • Get a few family docs and pay them a ton and I mean a ton (these are the toughest patients in the world).
  • Give them adequate staff to call these patients, visit these patients, etc.
  • Lastly, pay each of these patients $50 to show up to their regular visits.
  • Sorry, and one more thing, remove the EMTALA law for these patients and have a staff member (runner) literally walk them over from the ER to this new clinic when they show up.
  • The hospital and government would save millions of dollars each year.

Did they listen?  Yeah, right.  This article called Saving Lives and Saving Money showed how one group did do something.   Knowing that “frequent health care users representing just 1 percent of the patient population account for about one-fourth of health care spending”, they set out to do make a dent in the problem.

  • Paul Leon, CEO of the Illumination Foundation, a homeless health services group based in Irvine. Leon’s foundation runs the program, known as Chronic Care Plus, which has stabilized Meade and found him housing.
  • To break the cycle, Simmons conducts what is known as intensive care coordination. He helps the 37 participants, including Don Meade, find housing, get off drugs, get access to services, and make appointments with primary care doctors.

Here are the results from what this private group found:

  • The program saved $14 million in health care spending for just those 37 people over two years, compared with the two years prior to the launch of the program.

Once again, it proves how pathetic the government is at running programs and how small, private companies always do better.  It also proves that my plan would kick some serious ass and save this country an absolute ton of money.  It’s been three years and I am still waiting but the phone.

Douglas Farrago MD

Douglas Farrago MD is a full-time practicing family doc in Forest, Va. He started Forest Direct Primary Care where he takes no insurance and bills patients a monthly fee. He is board certified in the specialty of Family Practice. He is the inventor of a product called the Knee Saver which is currently in the Baseball Hall of Fame. The Knee Saver and its knock-offs are worn by many major league baseball catchers. He is also the inventor of the CryoHelmet used by athletes for head injuries as well as migraine sufferers. Dr. Farrago is the author of four books, two of which are the top two most popular DPC books. From 2001 – 2011, Dr. Farrago was the editor and creator of the Placebo Journal which ran for 10 full years. Described as the Mad Magazine for doctors, he and the Placebo Journal were featured in the Washington Post, US News and World Report, the AP, and the NY Times. Dr. Farrago is also the editor of the blog Authentic Medicine which was born out of concern about where the direction of healthcare is heading and the belief that the wrong people are in charge. This blog has been going daily for more than 15 years Article about Dr. Farrago in Doximity Email Dr. Farrago – [email protected] 

  6 comments for “Revisiting the Super Utilizer

  1. Maid Marriam
    July 4, 2016 at 3:39 pm

    As an ER nurse and I get to see tons of these “Super utilizers” ( I laugh when I read that). We nurses have discussed a blanket and sandwich stand just outside the ER would cut the flow of traffic by these people significantly.

    Just saying.

  2. Michael Silbert MD
    July 2, 2016 at 2:13 pm

    I resent the generalization ” it proves how pathetic the government is at running programs and how small, private companies always do better”. How well have the small generic drug companies done with their pricing? There are ineptitude and greed everywhere. That is why “Checks and Balances” are necessary.

    • Doug Farrago
      July 2, 2016 at 2:50 pm

      Sorry you resent that. Do you need a tissue?

  3. Sir Lance-a-lot
    June 28, 2016 at 2:12 pm

    At this point in my life, I think the best thing would be to just take ’em out behind the loading dock and shoot ’em.

  4. Pat
    June 28, 2016 at 12:20 pm

    Let’s hear bleeding heart politicians criticize THIS “top 1 %”.

  5. P
    June 28, 2016 at 7:46 am

    These solutions provided as you describe above would go a long way to easing the medical care burden for folks like this. But the gov’t continues to spend millions on runaway EMRs, PCMH, ACOs and other ridiculous programs.

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