Document Detail

Collaborative effort in Washington state slashes non-essential use of the ED by Medicaid patients, delivering millions in projected savings.
MedLine Citation:
PMID:  23544187     Owner:  NLM     Status:  In-Process    
Early data suggest a coordinated, state-wide effort has reduced non-essential use of the ED by 10% among Medicaid recipients in Washington state, and is projected to save the state an estimated $31 million in the first year of the approach. The effort includes the adoption of seven best practices by hospitals across the state.These include the creation of an Emergency Department Information Exchange, so that EDs can immediately access a patient's utilization history, strict narcotic prescribing guidelines, and regular feedback reports to hospitals regarding ED utilization patterns. The effort was prompted by threats by the state legislature to limit Medicaid payments for ED visits deemed not medically necessary in the emergency setting. The legislature backed down when emergency physicians in the state countered with their own proposal to reduce nonessential use of the ED. They worked with other health care groups in the state to develop the plan. Data on the first six months of the effort are included in a report to the state legislature by the Washington State Health Care Authority. Among the findings are a 23% reduction in ED visits among Medicaid recipients with five or more visits, a 250% increase in providers who have registered with the state's Prescription Monitoring Program, aimed at identifying patients with narcotic-seeking behavior, and a doubling in the number of shared care plans, intended to improve care coordination. Emergency providers say big challenges remain, including a need for more resources for patients with mental health and dental care needs.
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  ED management : the monthly update on emergency department management     Volume:  25     ISSN:  1044-9167     ISO Abbreviation:  ED Manag     Publication Date:  2013 Apr 
Date Detail:
Created Date:  2013-04-01     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9425690     Medline TA:  ED Manag     Country:  United States    
Other Details:
Languages:  eng     Pagination:  41-4     Citation Subset:  H    
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