Features, Finance, Health and Safety, Municipal Government, New York

Emergency Rooms: The Cost and Care Dilemma

August 26, 2019

By Christina Nelson

The emergency department is a place where extremes meet. People who have been in car crashes are alongside those with poison ivy and common colds. It goes without saying that emergency rooms provide important services,  but avoiding high cost visits and long wait times for less urgent ailments could be best for everyone’s health and wallets.

Up to 27% of emergency room visits are avoidable according to a study published in Health Affairs1. This is consistent with High Line Health’s findings. These visits, including sinusitis and ear infections, could generally be handled in an urgent care or primary care setting while allowing for more streamlined care and follow-up.

With High Line Health’s reports, it’s easy to identify opportunities for savings and education that specifically apply to your population. As an example, one client focused on education for its employees while simultaneously increasing its emergency room copay. With the greater employee knowledge and incentive to use appropriate care, the plan saw a decrease in emergency room visits of more than 20%, while seeing an increase in urgent care visits of 20%. For some employers, changes like this can lead to big savings.

With the proper analytics in hand, self-funded employers can easily take action, such as:

  • Educating members on appropriate levels of care
  • Promoting primary care usage, access and coverage
  • Adjusting provider networks to include urgent care and after hour alternatives to emergency rooms
  • Implementing telehealth programs

With the ever-growing options for healthcare, readjustment and education are key in ensuring health and savings. Reviewing data can provide insight to adjust and find real savings for plans and members. High Line Health is a healthcare data analytics company offering data solutions that identify action items for savings and help improve population health. For more information on how to generate savings for your Health Fund while maintaining access for your members, please visit www.highlinehealth.com or reach out to High Line Health at info@highlinehealth.com.

Weinick RM, Burns RM, Mehrotra A. Many emergency department visits could be managed at urgent care centers and retail clinics. Health Affairs. 2010;29(9):1630–1636.

August 26, 2019

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