Across Colorado and the US, roughly 20 percent of the population is responsible for 80 percent of the health care costs (www.cohealthdata.org). This disproportionate amount of spending on a few has led to what's been coined "hot spotting" - care coordination programs targeting high-risk, chronic condition patients aimed at reducing unnecessary ER visits and hospital stays. As sub-recipient of a federal innovation grant through the Center for Medicare and Medicaid Innovation (CMMI), Metro Community Provider Network (MCPN) in Aurora, CO, has seen over $145,700 in estimated cost-savings and a 63 percent reduction in utilization of hospital and ED services through their hot spotting care management initiative.