The High Price of Failing America’s Costliest Patients [nytimes.com]

Must admit I really enjoyed reading this blog post, especially about the practices at CareMore. Potentially, it highlights so many issues pertinent to caring better for people in the health system who have high ACEs histories. People would be aware that those with high ACEs histories see their doctors more often, on average, than those with low scores -- naturally, since it's well established now that there's a risk of their developing a wide range of physical, as well as "mental" disorders. Naturally, "trying to prove a negative" is  a hard research question -- Do "people with high ACEs scores tend to need fewer health services if they receive well integrated health services which include  caring for the psychological, emotional, and social, as well as the physical (nutrition, exercise, "heart rate variability" -- sympathetic and parasympathetic dysregulation) effects of their histories"? Not an easy question to address. The broad range of services, how they work in together, and the team based approach, all old ideas, but are still very important -- potentially very appropriate in secondary and tertiary care services, but highlighting the need for very good communication between those sectors and primary care providers -- often lacking in most cases.

The health service in which I operate, as one of the managers, has recently prohibited access to ACEsC due to the inordinate amount of time people need to spend separating the wheat from the chaff -- those matters relevant to health care -- but this was relevant to those issues. 

While I understand there might soon be a "group" in ACEsC focusing on primary care issues, more needs to be done to address those working in secondary and tertiary care areas -- our own group? But that runs the risk of not-so-good communication between primary care and other health services.