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High-Cost Commercial Claimants

The American Health Policy Institute (AHPI) defines high-cost claimants (HCC)
as those patients who cost $50,000 per year. In a 2016 study of 26 large employers, AHPI found that HCCs cost an average of $122,382 annually, and that they comprised 31% of total spending. Both payers and providers are concerned about the etiology behind the cost of care for these patients.

When the epidemiology and cost drivers behind high-cost claimants are better understood through data analysis, both providers and payers can utilize the levers available to them to alleviate the risks involved with some of these costs and improve outcomes.

 Published: September 2017

Type: FactFile

Length: 2 pages

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