Emergency Room
When the Legislature proposed limiting the number of ER visits medicare would pay for, there was a public uproar. Still, many state lawmakers say they need to cut health care costs and pricey visits to the emergency room is a great place to start. (AP file photo)

A new plan to cut down on emergency room 'frequent flyers'

BY Kim Shepard  on May 19, 2012 @ 2:15 pm (Updated: 11:43 am - 5/22/12 )

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.

Kim Shepard, KIRO Radio Reporter
Kim Shepard is a news anchor and reporter for KIRO Radio and the office optimist. She's energetic, quick to laugh and has a positive outlook on life.
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Comments (31)


  • Add A Comment

  • murr wrote...
    pretty simple
    May 21, 2012 2:43 am
    no insurance, get out of our way.
    { "Thumbs Up":"1","Thumbs Down":"-1" }
  • R L M 456 wrote...
    Better make sure the System Computers
    May 21, 2012 8:47 am
    Have the Spanish and Russian launguage packs installed

    That will serve 85% of the "flyers"

    { "Thumbs Up":"1","Thumbs Down":"-1" }
  • CH wrote...
    Republican't think it cheaper to use the ER - than have medical insurance . . . .
    May 21, 2012 3:01 am
    that why "they" are trying to overturn Obamacare.
    { "Thumbs Up":"1","Thumbs Down":"-1" }
  • RonJ wrote...
    And not a momement too soon will
    May 21, 2012 8:55 am
    this obamanation called obamacare e overturned.
    { "Thumbs Up":"1","Thumbs Down":"-1" }
  • HPD 5-0 wrote...
    CH...you are perfectly welcome to buy medical insurance yourself.
    May 21, 2012 10:07 am
    It's available. In fact, I bet lots of those evil Republicans buy it for themselves and their families. Oh...but you want ME to buy it for YOU......
    { "Thumbs Up":"1","Thumbs Down":"-1" }
  • Whidbeyboy wrote...
    We're 72nd, we're 72nd!!! Go USA!!!
    May 21, 2012 12:37 pm
    "In fact, I bet lots of those evil Republicans buy it for themselves and their families. Oh...but you want ME to buy it for YOU......" You already do, it's called Medicare. Plus charging someone for full spine x-rays that cost $2000 where insurance only pays $120, and those without insurance pay $2000? Insurance and medical care are serious issues and will not go away with "I have mine, you get yours" attitude. We spend 3 times the amount that Japans does and we are rated 72nd in overall health, where they are number 1? Hell, France was rated #4 by the WHO. Obviously, we are the unhealthiest nation that is not third world, and then many of them are doing better. Until we stop the drug, insurance and medical lobbiest from influencing the politicians to vote for more profits (like Bush's free drugs for grandma act) we will continue to slide down into a worse senario.
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  • mihalyim wrote...
    doctor's orders
    May 21, 2012 3:50 pm
    Funny since every time I call the doctor to try and get an appointment because my kid is sick they have none available and tell me to take them to the ER.
    { "Thumbs Up":"1","Thumbs Down":"-1" }
  • ron prevost wrote...
    A far more sensible and humane idea.
    May 21, 2012 5:48 am
    Not that any plan short of flat out denying treatment in ERs will be a solution, but this plan appears much more humane than that offered earlier by our state. Two things stand out with cross referencing. First (and best) double and triple prescriptions would be curtailed - hence less narcotic abuse. .. Second, but I may be reading wrong, is that perhaps those with a cough or a cold are either treated LAST of referred to a clinic or to return at a later time. Thus keeping ERs EMERGENCY ROOMS. ....... Back in the 60's, likely before malpractice costs got the better of them, younger doctors staffed 'free clinics' all around the country. If a few could be opened again, that also would be less pressure on the ERs. ... But St. Joe's has it right. Don't deny treatment to those who really need it.
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  • SeattleNative wrote...
    "They" are trying to overturn Obamacare...
    May 21, 2012 7:52 am
    ...because "they" still believe in the US Constitution.
    { "Thumbs Up":"1","Thumbs Down":"-1" }
  • Whidbeyboy wrote...
    Then gimme back my $$
    May 21, 2012 12:44 pm
    If it's against the constitution, tell your grandparents to pay me back all thre money I paid into the Medicare system. If they don't then are they not thieves?
    { "Thumbs Up":"1","Thumbs Down":"-1" }
  • myopinion wrote...
    In This State
    May 21, 2012 8:21 am
    Rather in all 50 states the Federal Goverment mandated that no one will be tured away from the E.R. "regarless of their ability to pay" without paying the hospital for those services. So what you have is E.Rs. being primary care givers to those underinsured, or, not insured at all. And even after you receive care if you don't have insurance you dont have follow up care so the only place left is the E.R. This crap about the State "educating" doctors on how to have a "conversation" with thier patients is not going to solve the problem of no insurance or underinsurance. And this Dr at St Joseph saying that, the next problem to fix is the broken health care system is an understatement. But regardless of those dreams of grandure, This broken system will not be fixed by doctors or any Goverment until you take profit out of a healthcare system and leave it in the hands of a faceless insurance company this is what you will have. And until individuals experience what it feels like to not have insurance and be injured, or have a serious health issue and be driven into bankrupsy only then will we have full healthcare regardless or our ability to pay. It also seems anytime we have tried to fix our system either the public does not like it or some Goverment official gets lobbyed to not pass it. The fact is insurance companies rule the roost, and we let them, we let them dictate how much time a Doctor spends with his/her patients tio how much they wiil be paid. And just incase you are not paying attention, most hospitals inthe Seattle area have closed, they now operate "Urgent Care" or clinics that you go to. Again you won't control health care costs until you get the insurance companies out of it. If it was not a profitable endevor for insurance companies then they would not be in the business of selling it.
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  • worhtalook wrote...
    No one with a genuine emergent need should be turned away from getting medical attention..but let me tell you, as a HEalth Care provider and PRofessionl
    May 21, 2012 10:33 am
    the ones filling the ER's are mostly not filled with thosse types of needs. It is filled however with drug addicts..who have od'd or have abscess's or developed other issues from using drugs, then we have the alcoholics who have also hurt themselves or are found down somewhere, then we have the non English speaking who require translators at over $90 per hour. There are so many that just come in because they are ususally on some type of medications they shouldn't be on, and are anxious so they panic and come to the ED where they are generally very ill behaved and demanding..loud..as are the other drug users and ETOH people. THe above mentioned are frequent visitors..well known, and yet, we cannot turn them away and they cost millions of dollars a month..when a drunk is found down, we have to give them MRI's over a period of time to ensure that the person will not come back later and sue. It is so bad and yet we take them in, try to fix them and they go out..with our tax dollars supporting them and their way of life only for them to repeat the cycle..THe illegals alone cost the hHospital MILLIONS of dollars a MONTH!!!! SOme of them work and are just as abe to pay as I am but they are not asked or required to pay one single dime!!If I need medical attention, I have to pay for it! IT is terribly expensive..I also believe the Insurance Companies and the Pharmaceutical COmpany's take advantage of athose of us that work, but Obamacare is NOT the solution. IT is being able to turn away the repeat drug abusers and Illegal's. That alone saves us Millions of dollars a MONTH!!!
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  • ron prevost wrote...
    worth a look in the mirror.
    May 21, 2012 12:33 pm
    If YOU are working ER, perhaps YOU should find somewhere else to provide service of get out of health care entirely. Warm and fuzzy, you are not. .. Regardless of decisions of the insurance and drug companies, IF you actually provide care, you are likely paid better than most of society - and I really doubt you are on profit share with your hospital. .................... That all aside. You may have frustrations, but are addicts and alcoholics less deserving of your treatment ??? .. Should a 4 year old child be turned away because her parents are 'illegal' ??? .., Perhaps Dr. Schlicher, coming from St. Joseph's, is on a different page from a for every dime I can get profit facility, but humanity will not turn the needy away. ................... No. Obamacare is not the answer. But it WOULD likely turn down junkies and drunks, as you imply. .. But neither these PEOPLE, nor 'illegals' are the core problem. ... I don't know, but at least the Dr. Schlicher's of this world are LOOKING for answers.
    { "Thumbs Up":"1","Thumbs Down":"-1" }
  • It's me! Ha ha! wrote...
    They already do.
    May 21, 2012 8:38 am
    It's called "Triage" Sadly they cannot refuse treatment but they can make the frequent flyers wait a very long time.
    { "Thumbs Up":"1","Thumbs Down":"-1" }
  • ron prevost wrote...
    my second point
    May 21, 2012 10:56 am
    but not so bluntly said. Treat all real emergencies first.
    { "Thumbs Up":"1","Thumbs Down":"-1" }
  • jstumbo wrote...
    They should refuse treatment...
    May 21, 2012 9:12 am
    if it is not a real emergency when you do not have insurance. Feeling sick with the flu, not emergency. Twisted your knee, not real emergency. Have chest pains, cut off your hand, those are emergencies. As for the illegals, they should not get any care at all. Problem is how to tell if someone is in the US illegally without just profiling. We really need a national ID card. Us citizens would have their ID card, legal immigrants would have their green card, visitors will have their passport and visa. Illegals will not have these documents and would be refused care. These documents should be required to open a bank account, rent a home, buy a car, license a car, get utilities, get government services, get a job, cash a check... If this happened, it would make it so tough on illegals that they would self deport.
    { "Thumbs Up":"1","Thumbs Down":"-1" }
  • worhtalook wrote...
    national ID card?
    May 21, 2012 10:40 am
    Well in States such as ours, illegals are given ID cards..even Drivers Licenses..I fully feel that EVERYONE using AMerican currency should HAVE to speak English, and of course I am not including those who are here to visit. I also feel that those found providing illegal documents to people should be put away for 30 years..but even repeat drunk drivers aren't put away..eve if they kill someone..and IF they go to Rehab..for the umteenth time, we the tax paying citizens these people put aat risk, are paying for that too..I will NEVER ever understand how some of you think that is fair and just..
    { "Thumbs Up":"1","Thumbs Down":"-1" }
  • jstumbo wrote...
    Back on subject...
    May 21, 2012 9:18 am
    I do not like the mandate to buy insurance in Obamacare. But would find a single payer system better. But then I have problems with that in that look how medicare is going, if we expanded that to everyone, imagine the costs. Between food stamps, welfare, section 8 housing, free medical care... does not even seem that it pays to work these days. I feel sorry about the person working a job close to minimum wage that cannot afford good food, good housing and medical care, when people that are sitting on their butts get it all given to them.
    { "Thumbs Up":"1","Thumbs Down":"-1" }
  • BigGovSux wrote...
    You've hit the nail on the head jstumbo...
    May 21, 2012 9:50 am
    Fact of the matter is, those that work (and the number is dwindling) support those that don't (that number is rising). We, as Americans, have been told ever since the great society that the government will take care of us. Both parties are responsible but it is the Democrats who have largely turned us into a nation of dependent whiners. Everyone looking for a handout from the government. Benjamin Franklin once said "When the people find that they can vote themselves money, that will herald the end of the republic.” We are getting to the tipping point in this country where, as it is now, almost half of the people are takers. They pay no income tax and actually receive more than they contribute. Politicians constantly tell us they are going to give us things in order to get reelected. With Obama, it was health care. With Bush, it was prescription drugs for seniors. None of these things fit within the priciples of America's founding and people have to wake up and realize that eventually, we will not be able to pay these unsustainable burdens.
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  • HPD 5-0 wrote...
    people have to wake up and realize that eventually, we will not be able to pay these unsustainable burdens.
    May 21, 2012 10:10 am
    One need only look to Europe for evidence.
    { "Thumbs Up":"1","Thumbs Down":"-1" }
  • HPD 5-0 wrote...
    Only the beginning.
    May 21, 2012 10:06 am
    Once "Owebama care" starts in 2014 the gubment will limit & ration medical care/treatment to us ALL. They'll have to; they (US) cannot afford to alternative and the Dimocrats know it. But they don't care. It's all about power, control and money. The Dimocrats need to control you to get your money ergo power over you.
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  • Camanoresident wrote...
    If you aint' legal
    May 21, 2012 10:47 am
    get the heck out of here. (out of the USA) I'm tired of waiting hours for the illegals in ER when some people are in real need.
    { "Thumbs Up":"1","Thumbs Down":"-1" }
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