ER best practices is music to state budget writers’ ears

Washington's Seven Best Practices initiative is improving care and reducing state Medicaid costs. The Washington State Health Care Authority reported that in its first six months, the initiative is saving the state more than 10 percent in Medicaid fee-for-service emergency care costs, which could result in as much as $31 million for the fiscal year. But these savings are just one of many achievements:

• A 23-percent reduction in emergency visits by Medicaid patients.
• Doubling the number of shared care plans to ensure patients receive coordinated care.
• A 250-percent increase in the number of providers registered in the state's Prescription Monitoring Program
• Increasing the number of hospitals exchanging emergency department information electronically from 17 to 85, and 10 more are in the process.
• Patients have fewer emergencies since a primary care physician is implementing a cohesive care plan for them.
• Prescription drug abuse has decreased.

The seven practices included in the 2012 Operating Budget are summarized below:

1. Tracking frequent ER users and exchanging patient information electronically with other hospitals.
2. Educating patients that the ER should only be used for true emergencies.
3. Designating staff to receive and circulate information on Medicaid clients.
4. Contacting primary care providers at the time of the emergency visit and relaying any issues regarding barriers to primary care.
5. Implementing narcotic guidelines that direct patients to primary care or pain management services.
6. Enrolling physicians in the state's Prescription Monitoring Program.
7. Designating emergency physician and hospital staff to review and provide feedback reports— and taking appropriate action.

For more information, you can read the report: "Emergency Department Utilization: Assumed Savings From Best Practices Implementation".

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