Even though supporters of healthcare reform believed the Patient Protection and Affordable Care Act would reduce the number of emergency room visits across the nation, a survey from the American College of Emergency Physicians debunked that theory: 75 percent of ER physicians reported an increase in visits to their ER since Jan. 1, 2014.
Ezekiel Emanuel, MD, PhD, believes he has the answer to the problem of reducing ER visits. The oncologist, bioethicist and former health policy adviser to the Obama administration, recently published an opinion piece in The New York Times titled, "How to Solve the E.R. Problem."
The solution he proposes is deceivingly simple: patient engagement.
"Changing behavior is very hard," Dr. Emanuel wrote. "It can't be accomplished just by providing insurance or a wellness program and wishing people good luck."
Dr. Emanuel cites a partnership in Washington between Group Health Cooperative, a nonprofit organization providing healthcare and insurance, and SEIU Healthcare NW Health Benefits Trust, which provides care to home healthcare workers. This strategy has reduced ER use by 27 percent over four years.
The plan works, Dr. Emanuel wrote, because it does more than just offer health insurance. It offers a cash incentive for members for completing certain steps like filling out a health risk assessment, it increased the co-pay for an ER visit to $200 while keeping urgent care co-pays at $15, it uses a social media campaign to educate workers on when an ER visit is necessary and when they should visit urgent care, and it reminds members about where urgent care centers are and how to schedule appointments there.
"The good news is that this strategy is not neurosurgery," he concluded. "It is a relatively simple set of interventions that could easily spread to almost every other employer and insurer."