Wammes et al. (2017) showed that many of the patients who are among the 1% with the highest healthcare costs are being treated for multiple conditions. This suggests that high healthcare costs are at least partly due to treatment for multiple conditions, each of which by itself may not be excessively costly. It is the accumulation of costs for multiple conditions that cause patients to become high-cost patients, and this has implications for cost-control policies. It may be more worthwhile to focus on improving efficiency in the treatment of conditions that occur frequently but have low or medium costs than on conditions with high costs but that occur infrequently.
Conflict of interest and financial support: none declared.