When members of the Legislature proposed limiting the number of emergency room visits medicaid would pay for each year, there was a public uproar. Still, many state lawmakers say cutting health care costs and pricey visits to the ER is a great place to start.
Starting this summer, hospitals all over the state will be taking part in a new project to cut down on emergency room visits for non-emergency situations. It is part of a state mandate included in the supplemental budget passed last month.
The collaborative effort between hospitals and ER doctors will incorporate a new computer system to help them better share information. Hospitals will be able to see if a patient has visited another emergency room recently. Doctors will be able to see how their performance compares with other physicians around the state. And, they will be able to cut down on narcotics abuse by seeing if a patient has already been prescribed a medication elsewhere.
Dr. Nathan Schlicher is an emergency physician at St. Joseph's Medical Center in Tacoma and a spokesman for the American College of Emergency Physicians. He says while ER doctors were not happy with the idea of limiting the number of visits patients that would be allowed, they do support the plan.
"We've got to do it. It's tough to deal with these folks sometimes. Eighty-five percent of them often have concurrent mental illness that are two out of three times going untreated, so they're tough conversations. But, they're the ones we have to have, and we're going to help folks do it," says Schlicher.
The professional group of Emergency Physicians is working with the state to educate doctors on how to talk to patients about the appropriate use of the ER.
"Waiting a day if you've got a cough or cold is probably a good thing," Schlicher says.
There is a small percentage of the population, many of them on medicaid, who Schlicher says will need more than just a talking-to. He says most emergency room "frequent fliers" have either a mental illness or substance abuse problem that is going untreated.
"Just saying that they shouldn't be in the ER, but not actually doing anything to fix the system is not a solution. So, that's the next step. We've got to work to fix the system," says Schlicher.
He admits getting people those services will come at a price, but he says it will save money on the emergency side of things.
The Washington State Health Care Authority projects $31 million in health care savings as a result of this new program. It is scheduled to be fully implemented by July 1.