Using the same basis, we hypothesized that 80% of healthcare’s spend is consumed by 20% of the patients. As luck (or more appropriately science) would have it, we were not far off. Using our 3.5 billion claims in 2015 and 2016, we found that 80% of the spend is consumed by 17.8% of the patients. In healthcare, like land ownership in Italy, a large portion of our expenditures as an industry is being consumed by a small percentage of users. Most of this phenomenon in healthcare is driven by multiple chronic diseases which affects a disproportionately growing number of Americans.
Today, we are merely understanding how utilization translates into different care options for patients. What if we could lower healthcare costs by 20% by just getting the right patients to the right providers? We will dig into this more at a later date.