Tracking Medicaid beneficiaries who frequently use emergency departments and adopting electronic tracking systems to exchange patient information is among one of the ways states can cut Medicaid costs, according to a new report by the Washington Health Care Authority (HCA).According to a press release issued by The Washington Chapter of the American College of Emergency Physicians (WA-ACEP), preliminary data from the first six months of a study in Washington suggests the state is saving more than 10 percent in Medicaid fee-for-service emergency care costs by following seven best practices
- Tracking frequent users of emergency departments and adopting electronic tracking systems to exchange patient information;
- Disseminating patient educational materials about appropriate settings for health care services — to be provided at arrival or at discharge;
- Designating personnel and emergency physician personnel to receive and appropriately disseminate information on Medicaid clients;
- Contacting primary care providers at the time of the emergency visit and relaying any issues regarding barriers to primary care;
- Implementing narcotic guidelines that direct patients to primary care or pain management services;
- Enrolling physicians in the state’s Prescription Monitoring Program;
- Designating emergency physician and hospital staff to review and provide feedback reports— and taking appropriate action.
Andy Sama, MD, president of ACEP said, “Clearly, this is a model for the nation.”
The report, “Emergency Department Utilization: Assumed Savings From Best Practices Implementation,” analyzes the results of the best practices implemented through a partnership between the Washington Chapter of the American College of Emergency Physicians (WA-ACEP), the Washington State Medical Association, the Washington State Hospital Association and HCA.
The program was developed in response to the legislature’s call for a policy solution to high emergency department use by Medicaid patients, according to WA-ACEP officials.
The study shows the achievements of the “ER is for Emergencies” program include:
- A 23-percent reduction in emergency visits by Medicaid patients with five or more visits during the first 6 months of the program.
- Projected savings of $31 million to the state for the fiscal year.
- Doubling the number of shared care plans to ensure patients receive coordinated care.
- A 250-percent increase in the number of providers registered in the state’s Prescription Monitoring Program, which is designed to identify patients with narcotic-seeking behaviors.
- Increasing the number of hospitals exchanging emergency department information electronically from 17 to 85, with 10 more in the process of implementing the exchange system.
“In addition to cost savings, the program offers benefits to patients and hospitals,” said Stephen Anderson, MD, immediate past president of WA-ACEP. “Patients have fewer emergencies when a primary care physician is implementing a cohesive care plan for them. Prescription drug abuse is decreased. Hospitals can compare performances with their peers, identify and share best practices, and help patients receive care in the most appropriate and cost-effective setting.”
The full report can be downloaded from the HCA website here.