As CMS grows its partnerships with states to improve the value of healthcare, it has placed a particular focus on improving use of emergency care. In an informational bulletin, CMS discusses three key strategies to reduce inappropriate emergency department use:
1. Broaden access to primary care services. Extending primary care may allow beneficiaries to be seen in primary care settings more easily. Strategies for improving access to primary care include fostering the development of primary care medical homes and alternative primary care sites.
2. Focus on frequent ED users, or "super-utilizers." These patients, who visit an ED four or more times in one year, account for between 4.5 and 8 percent of all ED patients and between 21 and 28 percent of all ED visits. To target super-utilizers, CMS suggests locating an ambulatory clinic on site at the ED or investing in addressing super-user needs through medical home and community interventions.
3. Target needs of people with behavioral health problems. People with mental health problems make up 12.5 percent of ED visits. CMS suggests the use of medical homes for people with substance abuse problems or housing and case management programs.
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