In the first six months of implementing seven best practices, Washington state emergency departments reduced Medicaid patients' "unnecessary" ED visits by 23 percent and saved costs that are estimated to reach $31 million for the fiscal year, according to a report of preliminary data by the Washington Health Care Authority.
The initiative, called the "ER is for Emergencies Program," began in July 2012 in response to the state legislature's call for a solution to high ED use by Medicaid patients. The Washington State Medical Association, the Washington State Hospital Association, the Washington Chapter of the American College of Emergency Physicians and the Washington State Health Care Authority partnered to implement the following seven best practices in Washington hospitals:
1. Adoption of a system to exchange patient information electronically among EDs
2. Adoption of a system to educate patients that the ED should be used for only true emergencies
3. Implementation of a process to disseminate lists of frequent users to hospital personnel to ensure they can be identified by the electronic information exchange system discussed above
4. Implementation of processes to assist frequent users with their care plans and to make appointments for these patients to see their primary care provider within 72 to 96 hours of their ED visit
5. Adoption of strict guidelines for the prescribing of narcotics
6. Enrollment of at least 75 percent of ED prescribers in the state's Prescription Monitoring Program by July 1, with a goal of 90 percent enrollment by December 31, 2012
7. Designation of hospital personnel to review feedback reports regarding ED utilization and to take appropriate action in response to the information provided by those reports.
The HCA's report, "Emergency Department Utilization: Assumed Savings From Best Practices Implementation," showed that ED use by Medicaid patients with five or more visits decreased 23 percent. In addition, preliminary data indicate the state is savings more than 10 percent in Medicaid fee-for-service emergency care costs, according to the report.
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The initiative, called the "ER is for Emergencies Program," began in July 2012 in response to the state legislature's call for a solution to high ED use by Medicaid patients. The Washington State Medical Association, the Washington State Hospital Association, the Washington Chapter of the American College of Emergency Physicians and the Washington State Health Care Authority partnered to implement the following seven best practices in Washington hospitals:
1. Adoption of a system to exchange patient information electronically among EDs
2. Adoption of a system to educate patients that the ED should be used for only true emergencies
3. Implementation of a process to disseminate lists of frequent users to hospital personnel to ensure they can be identified by the electronic information exchange system discussed above
4. Implementation of processes to assist frequent users with their care plans and to make appointments for these patients to see their primary care provider within 72 to 96 hours of their ED visit
5. Adoption of strict guidelines for the prescribing of narcotics
6. Enrollment of at least 75 percent of ED prescribers in the state's Prescription Monitoring Program by July 1, with a goal of 90 percent enrollment by December 31, 2012
7. Designation of hospital personnel to review feedback reports regarding ED utilization and to take appropriate action in response to the information provided by those reports.
The HCA's report, "Emergency Department Utilization: Assumed Savings From Best Practices Implementation," showed that ED use by Medicaid patients with five or more visits decreased 23 percent. In addition, preliminary data indicate the state is savings more than 10 percent in Medicaid fee-for-service emergency care costs, according to the report.
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