Multi Visit Patient (MVP)

Often called “high utilizers” or “frequent flyers,” multi-visit patients (MVPs) are the small percentage of hospitalized patients who account for a disproportionately high proportion of admissions and readmissions. Coined by Dr. Amy Boutwell,MD MPP,  Multi Visit Patients are those identified with four or more admissions over a 12 month period of time.  These patients are high utilizers and often have complex medical needs.  MVP’s have unmet behavioral and social needs driving their utilization. Utilization is a symptom of that unmet need.  Alaska hospitals are embracing whole person transition care for those patients with complex social and medical needs adopting the following steps to help address the non medical factors contributing to their high utilization.  Areas of focus include:

  • Identify: The ability to identify those patients with frequent readmissions.                          
  • Assess : Utilizing standardized assessment tools to help identify their needs holistically (social, emotional, spiritual, financial, physical).                   
  • Develop a Plan: Co-develop with the patient and their caregivers, while seeking the support and guidance of a multi disciplinary team,  establish a plan to address unmet needs,              
  • Link: Provide a connection to resources within their community, not just a referral, but a warm hand off to people who can truly assist.              
  • Plan for Return: Provide a way to identify MVP’s  within the electronic health record and include a plan for their return to include notification of their care team, review and addressing gaps within the system, referral and reconnection to appropriate resources.

Link & Resources

A feasible, adaptable, effective method for improving care for high utilizers: Dr. Amy Boutwell MD, MPP