Dive Brief:
- Providers and health plans need to educate patients about where to seek care for non-acute medical issues, to avoid overusing emergency rooms and reduce costs, wrote Bruce Broussard, CEO of Humana.
- Broussard notes many people with chronic conditions go to the ER for medications or other services rather than their primary care physician, hampering ER physicians’ ability to tend to life-threatening situations.
- ER use is not only costly — the price of an ER visit jumped 10.5% to about $1,863 last year, according to the Health Care Cost Institute — it’s also less transparent, with test results rarely passed along to the patient’s PCP, Broussard says. He offered a five-point plan for curbing ER use.
Dive Insight:
“Hospitals and health plans spend way too many resources debating what was classified as an admission and whether it should have been classified as an observation,” Broussard wrote. “Given the fact that 71% of ER visits could have been avoided, more emphasis must be place on and resources devoted to alternatives that can prevent ERs from being overloaded.”
To ease the burden on ERs and rein in rising costs, Broussard recommended the following:
- Allow PCPs to be more proactive in coordinating care among specialists.
- See that patients get specialist care before a complication arises that could land them in the ER.
- Improve adherence to medications, including information about overdose and adverse drug reactions.
- Educate consumers on when to visit the ER versus an urgent care facility.
- Encourage technologies such as telehealth and predictive analytics that expand access and target patients in need of care.
Because of its lower cost and convenience, telehealth has the capacity to siphon off patients from both ERs and urgent cares, Shawn Borich, a regional director with ECI Healthcare Partners, told Healthcare Dive recently. But urgent cares also offer savings, at 10% to 20% the cost of an ER for the same complaint, he said.
In January 2015, the Health Care Service Organization launched a “Where You Go For Care Matters” campaign aimed at getting its members talking about appropriate ER use. The campaign offers information and advice where to get appropriate care for common medical conditions ranging from minor cuts to broken bones to heart attacks. It also provides information about patient wait times and costs.