Insightful new healthcare research from the RAND Corp. emphasizes the growing influence on healthcare spending based on decisions made by the 4 percent of U.S. physicians who work in emergency rooms.
Commissioned by the Emergency Medicine Action Fund, the new analysis proposes that emergency physicians serve as the major decision makers for nearly half of all hospital admissions in the U.S. And when the average cost of a hospital stay is 10 times that of an ER visit, that puts those departments in the hot seat for deciding which patients need to be admitted and which can be cared for in other settings.
Office-based physicians are relying more on emergency departments too. Using public-access data from five nationally representative surveys, RAND researchers determined that the growth in inpatient hospital admissions between 2003 and 2009 was attributed to a 17 percent rise in unscheduled hospital admissions from emergency departments. On the other hand, admissions from referrals by an office-based physician dropped 10 percent and suggests that physicians are directing more patients to the emergency department instead of directly to the hospital.
When Investment Rhymes with Canada
Canada has a proud history of achievement in the areas of science and technology, and the field of biomanufacturing and life sciences is no exception.
“Whereas policymakers and third-party payers have largely focused on the cost of ED care relative to treatment in other outpatient settings, the role of EDs in either facilitating or preventing hospital admissions may be a bigger story,” the authors wrote.
So charging higher co-pays or turning away patients from the emergency department probably isn’t the best way to drive down costs. “Efforts to reduce non-urgent and non-emergency use of emergency departments oversimplify a complex problem, and should instead focus on increasing access to affordable options outside the emergency room,” said Dr. Andy Sama, president of the American College of Emergency Physicians, in a statement.
Other stakeholders seem to be catching on to that too. St. Luke’s Hospital in Iowa used a $50,000 grant from Transamerica to launch a popular Emergency Department Consistent Care Program that helps connect frequent ER visitors with primary care providers and coordinate visits with other health professionals. After one year, people who visited the ER 12 or more times in a year reduced their ER visits more than 60 percent.
Many payers take similar strategies. Optum Health, for example, has a decision support solution that engages with patients after every emergency room visit to reinforce the primary care provider relationship, educate ER users on alternatives and refer them to health management programs.
A Personalized Approach to Medication Nonadherence
At the Abarca Forward conference earlier this year, George Van Antwerp, managing director at Deloitte, discussed how social determinants of health and a personalized member experience can improve medication adherence and health outcomes.
“Policymakers, third-party payers, and the public should be aware of the various ways EDs meet the healthcare needs of the communities they serve and support the efforts of ED providers to more effectively integrate ED operations into both inpatient and outpatient care,” the authors concluded.
