Cutting Costs Through Close Attention to the Largest Sources of Spending

With patients whose chronic health conditions mean that they need long-term care, there are a number of ways in which they impact the health systems they take part in. Patients with long-term conditions, for example, might need regular doctor's visits for decades before aging out of a given system, building up costs all along.

While hands-on care is often the most dramatic example of this fact, the reality is that are plenty of other analogs that are often nearly as significant in terms of their impact. Drug costs for a patient who is prescribed the same medication for decades, for example, can sometimes even make doctors' bills pale in comparison, further adding weight to the burden these especially needy patients impose on a given system.

Because of this, it only makes sense to look for ways to cut down on the spending that such patients impose on a hospital, an insurer, or other health care organization. This relatively new field is known as Specialty Benefit Management, and it has produced some promising progress in the space of a little over a decade.



The essence of specialty benefit management is to look for ways to reduce the costs imposed by those who are normally the most demanding of all. For example, one common myNEXUS approach is to seek out alternatives to the expensive, name-brand drugs that many doctors prescribe virtually out of reflex. If health professionals become aware of the availability of equally efficacious generic equivalents, they can quickly become an important part of an overall drive toward cost-cutting.

It can even make sense to look at ways of cutting the costs of dispensing drugs to those with long-term health conditions. Although this arena of benefits management has not yet been as well explored as many others, some early results do show great promise. Simply working to computerize drug administration and dispensing procedures, some researchers have found, can produce savings of 10% or more compared to sticking with the usual way of doing things.

The important thing, then, is not to look at these neediest of patients as an inevitable drain upon a given health care system. While it is likely the case that patients of this kind will always consume an especially large share of resources, that also means that cutting costs associated with them can be especially rewarding. This growing awareness of the power of benefit management, in fact, has likely been one of the most positive developments in the health care industry over the course of the last decade.