http://www.commonwealthfund.org/publications/in-brief/2016/jul/caring-high-need-high-cost-patients-urgent-priority?omnicid=EALERT1072635&mid=henrykotula@yahoo.com

Meaningful improvement in the health system will require improvement in care for those patients using it the most: people with multiple chronic conditions. Within this clinically diverse group are patients who remain stable for years with appropriate treatment, others who live with extreme functional limitations, and still others with persistent behavioral health challenges or related social needs, like housing or food, that exacerbate their conditions. Care for these high-need, high-cost patients is expensive: despite comprising just 5 percent of the U.S. population, they account for 50 percent of the nation’s annual health care spending.