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WSHA News

January 24, 2013

Implementing Emergency Room Best Practices Improves Care, Reduces State Medicaid Costs


A new report on a collaborative effort of hospitals and physicians to reduce “unnecessary” emergency room visits and coordinate patient care also contains good news for the state budget. Preliminary data from the first six months of the initiative suggest the state is saving more than 10 percent in Medicaid fee-for-service emergency care costs.  Accumulated savings could reach $31 million for the fiscal year.

Washington Governor Jay Inslee praised the partnership of legislators, the Health Care Authority, hospitals and health care professionals that pulled the emergency room initiative together.

“This is the kind of creative thinking, new approaches and collaboration that I want to foster in health care,” Inslee said. “Not only is the system saving money and physicians’ time, it is also improving the quality of care by making sure patients receive treatment that is both appropriate and timely.”

“We all want what is best for patients, and that means providing care in the most appropriate and cost-effective setting,said Dr. Nick Rajacich, President of the Washington State Medical Association (WSMA). “Working together we were able to reduce costs and improve care.”

The report, “Emergency Department Utilization: Assumed Savings From Best Practices Implementation,” was just released by the Washington Health Care Authority (HCA). It analyzes the results of a coordinated program of seven best practices implemented through a partnership between WSMA, the Washington State Hospital Association (WSHA), the Washington Chapter of the American College of Emergency Physicians (WA-ACEP) and the Washington State Health Care Authority (HCA). The program was developed in response to the legislature’s call for a policy solution to high emergency department use by Medicaid patients.

“This program is a great example of the success public/private partnerships can have in applying evidence-based solutions to problems,” Acting HCA Director MaryAnne Lindeblad said. “Through shared best practices and cooperation, we all win.”

Through the ER is for Emergencies Program, all hospitals in Washington State agreed to implement seven best practices to redirect care to the most appropriate setting, reduce the number of low acuity patients, and reduce preventable Medicaid emergency visits. While the state’s report focuses on care for Medicaid clients, hospitals are applying these best practices for promoting consistent, coordinated care to all patients.  Program achievements to date include:

  • A 23%      reduction in emergency room visits by Medicaid patients with five or more      visits
  • 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% 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

“As an emergency department physician, I want my patients to receive the best possible medical care,” said Senator Dr. Nathan Schlicher. “This statewide effort works toward real cost savings while protecting quality patient care and safety.”

In addition to cost savings, the program offers other benefits to patients and hospitals. Patients are more likely to receive appropriate care from a physician who is able to follow a cohesive care plan for their ailments. Prescription drug abuse is decreased. Hospitals are able to compare their performances with their peers, identify and share best practices, and help patients receive care in the most appropriate and cost-effective setting.

“The ER is for Emergencies program is a prime example of the way health care organizations are working to transform care delivery,” said Scott Bond, CEO of the Washington State Hospital Association. “We are partnering across organizations and with government agencies to engage and improve the system.”

HCA is planning another assessment in October 2013 to assure the program is achieving its targeted yearly savings of $31 million.

The full report can be downloaded from the HCA website http://www.hca.wa.gov/leg_reports.html

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Jim Stevenson (HCA) 360-725-1915  jim.stevenson@hca.wa.gov

Pauline Proulx (WA-ACEP) 206-956-3648 plp@wsma.org

Beth Zborowski (WSHA) 206-577-1807 bethz@wsha.org

Susan Callahan (WSMA) 206-794-4706 slc@wsma.org

 

The Washington State Health Care Authority operates the two largest health care purchasers in state government – the Medicaid program for low-income state residents and the Public Employees Benefits system, which provides health care benefits to state employees and retirees and their dependents.

The Washington State Hospital Association represents all of Washington’s 98 community hospitals. The association takes a major leadership role in issues that affect delivery, quality, accessibility, affordability, and continuity of health care. It works to serve its members, increase access to health care, and improve health care quality.

The Washington Chapter of the American College of Emergency Physicians exists to support quality emergency medical care. The organization is widely recognized as the voice of emergency medicine and engages in frequent communications with the general public, key interest groups, and the media about the role and value of emergency medicine in the health care delivery system. WA/ACEP is a unifying force for emergency medicine physicians facing new challenges in a rapidly changing health care environment.

The Washington State Medical Association’s vision is to make Washington the best place to practice medicine and to receive care. The WSMA represents over 9,800 physicians throughout Washington state. For more information about the WSMA, please visit www.wsma.org.

 


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