NJ Hospital Project Cut Medicaid Patients' Inappropriate ED Use by 47%

May 10, 2012 | Print  |

The New Jersey Hospital Association announced a project at two New Jersey hospitals decreased inappropriate emergency department use by Medicaid patients by 47 percent over two and a half years.

The project, Community Partnership for ED Express Care and Case Management, was conducted from September 2008 through April 2011. NJHA's Health Research and Educational Trust, the state Department of Human Services and the New Jersey Primary Care Association tracked ED visits at Newark Beth Israel Medical Center in Newark and Monmouth Medical Center in Long Branch.

The EDs implemented an express care process in which ED patients with non-emergency conditions were assessed by a clinician, provided the necessary care and referred for a follow-up visit with a primary care provider. If the patient did not have a primary care physician, the hospital immediately scheduled the patient for an appointment at the partnering federally qualified health center — the Newark Community Health Center for Newark Beth Israel and the Monmouth Family Health Center for Monmouth Medical Center.

ED staff also educated the patient on the appropriate site of care for various healthcare needs, and case managers at the EDs and health centers coordinated transportation and support services, according to the release.

Key findings on utilization differences from September 2008 through April 2011include the following:

•    ED visits for primary care needs decreased 22 percent while overall ED visits increased by 1 percent.

•    Overall patient volume at the community health centers increased 19 percent.

•    Medicaid patient volume at the community health centers increased 30 percent.

•    Patient turnaround time in the ED decreased an average of 15 percent.

However, these findings may be limited by the fact that only two hospitals' EDs were studied.

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