Costs concentrated among top 1

A recent study underscores the intuitive fact that a small percentage of patients consume a disproportionate share of healthcare dollars. For some populations, the concentration is even more dramatic than the old 80/20 rule. It's such an important point that sometimes it gets lost, says Nancy Chockley, president and CEO of the National Institute for Health Care Management Foundation, the study's sponsor. The foundation's findings show that just 1% of patients use 20% of all healthcare dollars and that the top 5% of high-cost patients account for nearly half of all spending. New care delivery models, a focus on disease management and more effective end-of-life care all show promise, but each has its limitations.