As ballooning medical costs continue to raise national concern, analysts and policymakers have directed significant attention to the challenges posed by high utilization. Most research and intervention thus far have focused on increasing coordination of care and developing medical homes for patients who are frequently grappling with multiple, chronic, physical and behavioral health conditions, however, the greater attention on high utilization provides an additional opportunity to reduce patterns of high utilization across the population by applying prevention methodology. A comprehensive strategy to address the challenges of high utilization should include methods that prevent illness and injury in the first place.
This paper presents an exploratory methodology for disrupting the pathway that leads to high utilization by applying a community-wide prevention lens to the challenges of high utilization. The rich body of prevention research, practice, and experience supports the notion that this approach can add value to existing efforts by the healthcare system - by reducing the pipeline to high utilization, supporting the maintenance and restoration of health and well-being, and improving the health of the population. The ideas presented here are preliminary and meant to catalyze further thinking about the potential value of prevention in reducing medical high utilization.