Dive Brief:
- A new case study from the Agency for Healthcare Research and Quality has concluded that sending out near real-time alerts to health plans when a member is admitted to the hospital or ED cost less and could be more effective than using an HIE.
- To examine the issue, Indiana Health Information Exchange programmers created an application which sent daily alerts about health plan members who visited EDs at nine Central Indiana hospitals. The alerts were sent to the health plan within 24 hours, which took steps to replace non-urgent ED visits with primary care visits.
- Over the six-month pilot, the participating health plan reduced non-emergency ED visits at participating hospitals by 53%, while primary care visits among plan members increased by 68%.
Dive Insight:
I'd say this pilot would have to be classed as a success, most particularly because the alerts and resulting behavior changes lead to savings of $2 million to $4 million over six months. This is not to downrap HIEs, which have a large and growing role in both improving care and reducing waste. But it does suggest that health plans may benefit from making a small change of this kind -- reviewing a single data point amid millions -- and should pursue models like this elsewhere in the country.