West Virginia hospital's new copay policy aims to curb nonemergency visits in the ER

South Charleston, W.Va.-based Thomas Memorial Hospital hopes to reduce visits to its emergency room by charging upfront copays to patients who visit the ER for nonemergency care. The hospital will begin charging copays in August.

Dan Lauffer, president and CEO of Thomas Health, recently answered questions from Becker's Hospital Review about the initiative and how people have responded.

Note: Responses have been lightly edited for length and clarity. 

Question: How does the initiative work?

Dan Lauffer: We're in the beginning stages of educating our patients who present with a nonemergency issue in our ER that a copay will be collected. They can choose to be seen in our care clinic, which is 15 feet away from the waiting area of the ER — at a reduced cost and shorter wait time. We're trying to change the thought process of our culture to learn how to properly access the system. If we don't do this, the system will never change.

Q: Why did the hospital choose to implement this initiative?

DL: The reason we chose to do this is because we wanted to change the culture and teach our community how to get the care they need in the proper setting. About 30 percent to 40 percent of our ER visits are nonemergency visits, and I think that's partly why we need to emphasize the usage of our care clinics; to give them the access to care that they need in the setting that's best suited for their issue.

Q: How many patients will this affect?

DL: We have a total of 35,000 visits in the ER annually, both for emergency and nonemergency care. About 30 percent of those patients present with nonemergency issues.

Q: What is the ultimate goal of the initiative?

DL: The ultimate goal is to educate the community about the care they have access to and how to use it properly, and that is what we as a healthcare organization should do. Think about it — fee-for-service was predicated on volume, and now we're shifting toward fee-for-value, so it is to our advantage to try to educate our patients the best way possible.

Q: How are people reacting to this initiative?

DL: By in large I think people are appreciative of the fact that we are making a strong effort to educate our patients about the system. Naturally there's one or two people who have complained but overall it's been well-received.

Q: Do you think other hospitals will follow suit by implementing a similar policy?

DL: I think so. As far as we know, we are the only health system in the state who is working on this effort.


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