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Description: High-need, high-cost patients (HNHCPs) are individuals who endure medically and socially complex circumstances when navigating the healthcare system. While accounting for 5% of the total patient population, they incur nearly 50% of total Medicare and Medicaid healthcare expenditures. The fragmented nature of US healthcare exacerbates these already difficult situations, especially for those with little to no insurance coverage. This negatively impacts the health of the most vulnerable patient populations, widening healthcare disparities and contributing to inefficient healthcare spending. In Georgia, this predicament is particularly pronounced. The state ranks third nationally for its uninsurance rate and has had the third highest number of hospital closures in the United States. Grady Memorial Hospital, Atlanta’s safety-net hospital, faced near closure in 2007 due to financial strain. Grady is one of the only hospitals where underserved and underinsured patients can have access to healthcare in the Metropolitan and surrounding areas.    In light of social and medical challenges that HNHCPs face in establishing continuity of care, safety-net health systems have employed programs to address social determinants of health among underserved populations. These interventions are not just necessary for the underlying moral goals of safety-net healthcare, they are also crucial for hospital budgets by reducing unnecessary resource utilization.


  • Anders Olson, Medical Student, Emory School of Medicine