Application of Hotspotting in Acute Care Settings

In the United States, the costs of health care delivery and services continue to increase across federal, state, and private sectors despite attempts to reduce expenditures.^1,2  Research on this issue has resulted in identification of the super utilizers (SUs): high-needs, high-cost patient populations.^1–8  Super utilizers have multiple complex social and medical needs that are unmet because of deficits in their social determinants of health, including environment, economic stability, and social supports.⁹  These patients’ enormously high health care use are indicated by frequent emergency department visits and hospital admissions that result in fragmented care and excessive costs. Notably, many SUs are Medicaid beneficiaries, and although they make up only 5% of the Medicaid population, they account for 50% of the total program spending.^3–6  This disproportionate cost accumulation has been attributed to a systems failure in which SUs are unable to manage...