Apr. 3—Washington state hospitals reduced Medicaid emergency department (ED) visits by 10 percent after the state required them to use a data-sharing system that tracked beneficiaries' use of emergency hospital care, according to a new report

The Washington State Health Care Authority report assessed the mandatory requirement implemented in July 2012 that hospitals use the Emergency Department Information Exchange to track patients’ ED use. The program sends patient information to a database when they register at an ED. Then, the exchange gives clinicians a list of recent ED visits by the patient.

“The electronic information system allows physicians to see all of the patient’s emergency room visits from all hospitals over the past 12 months, and to know the diagnosis and treatment given on these previous visits,” wrote the authors of the report. “If a patient is seeking narcotics or has a chronic condition, the emergency department physician will know this and will respond accordingly.”

The network also has registered 424 primary care physicians to receive automatic notifications whenever one of their patients goes to the ED. 

Other findings from the first year of the initiative included a 24 percent reduction in narcotics prescriptions issued for Medicaid beneficiaries and a decline in Medicaid ED costs by $33.7 million in FY13.

Additional components of the initiative include the EDs’ adoption of systems to educate patients that the facilities should be used only for true emergencies. In addition to training ED physicians on how to talk to patients about appropriate care locations for non-emergent needs, the hospitals created care plans to assist frequent users and make appointments for these patients to see their primary care provider within 96 hours of their ED visit.

Next steps for the program include preparing for an increase in the state’s Medicaid population due to the Affordable Care Act’s expansion of eligibility by working with managed care plans to educate beneficiaries on appropriate ED use. Some states have found ED use increased under previous expansions of Medicaid rolls.

Publication Date: Thursday, April 03, 2014