As hospitals are coping with the move from a volume- to a value-based healthcare world, emergency medicine and emergency department practices can be of great help, according to John Holstein, the director of Zotec Partners.
He discussed the topic at the Becker's Hospital Review 6th Annual Meeting in Chicago May 9.
"I think emergency medicine can offer a great value statement to our healthcare industry and can very well fit into the new evolution of healthcare," Mr. Holstein said.
For example, physicians in the ED are "pivotal" in the transition of care and can play a large role in reducing unnecessary admissions and readmissions.
However, the ED is subject to the challenges presented by changes due to healthcare reform and the aging population. For example, the acuity of patients visiting the ED is rising, and the payer mix is changing as well.
High-deductible health plan patients present a unique problem, as self-pay patients can hurt an ED physician practice. "I would suggest that…yesterday's protocols, technology and processes are just not going to work with these patients," he said.
Mr. Holstein suggested using a balance of real people on the phone engaging the patients and possibly communicating with the patient's via texting to get them to pay for their services.
Patient engagement through patient portals is also of upmost importance for high-deductable patients and just patients in general. "We need to have multiple touch points with patients today in order to maximize our ability to collect," he said. "We need to be creative in how we engage the patients and use multiple approaches."
Benchmarking the ED practice to show its worth is increasingly important to prove its value, Mr. Holstein said. "We need to be on top of the data." He suggested monitoring the following in an ED practice:
- Age bracketing
- Patient flow
- Critical care services
- Mental health services
- Clinical diagnostics
- Therapeutics
Other metrics to benchmark include:
- Door-to-doctor
- Door-to-balloon
- ED time after admit decision
- ED time before leaving ED
- CT scans per provider
- Patient satisfaction scores
"As we grow and move toward more value-based purchasing and toward more accountability for our services, I really believe alliances with emergency physicians are critically important in our hospitals today," he concluded. "I believe they offer the expertise, the information, the data, the metrics, to really contribute to be a game changer in our healthcare industry today."