Thursday, May 9, 2013

Hospitals Crack Down on ED Repeat Users

Health Leaders Media published an article titled: "Hospitals Crack Down on ED Repeat Users". Key points from the article were as follows:
  • Case Manager Plan
    • St. Luke's Hospital implemented a plan to identify those who were "frequent fliers" patients who visited the ER 12 times in 12 months.
    • Many of these patients go to the ER for various reasons such as: they don't have a family doctor, they lack finances or they may be unable to make their doctor's hours.
    • This hospital has estimated that they have saved about a half million dollars by not having to provide additional care and testing for these so-called "frequent fliers"
  • Creating a Direct Relationship
    • In Massachusetts, many of their "frequent fliers" or as they called them "MVPs" did have primary care physicians.
    • The issues that these patients dealt with were more psychological, social and economic issues.
  • Following the Care Plan
    • Patients receive a letter if they have gone to the ER for more than 12 times.
    • They make sure the patient understands the treatment program from their last Emergency Department discharge.
  • Technology and Diabetes
    • The article stated that in one study 11% of ED visits at two particular hospitals was for diabetic visits.
    • They came to the conclusion that patients were not getting the care they needed.
  • Behavioral Care and Insurers
    • Lack coordination which results in a negative impact on individuals
  • Changing Behavior
    • The change for these Emergency Departments has shown good results
  • No Cure Yet
    • Although, improvements have helped at many hospitals, the problems with frequent fliers in the Emergency Department still has a long ways to go.
To download the full article, please click the following link: Hospitals Crack Down on ED Repeat Users

For additional billing and coding resources, please click the following link: Medical Reimbursement Resources Page

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