Based on the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), Medicare payment incentives for physicians to improve the value of health care are ascending toward maximum adjustments in 2022. With this shift, greater attention will be paid to mitigating the danger and cost of health crises for high-need, high-cost older adults.
Several consistent themes emerge from relevant literature. The high-need, high-cost population is not homogeneous, obviating application of a single strategic approach to achieve value. Although not commonly measured, functional status, which is not fully discerned by diagnostic codes in Medicare billing data, has an enormous effect on costs. Finally, the highest-spending population segment has substantial annual turnover, although less so among high-need, high-cost seniors.