5 Interventions to Reduce Avoidable ER Use by the Medicaid Population
Twice as many Medicaid patients visit the ER as their insured counterparts, largely due to barriers to primary care access, according to a study published online in the March 2012 in Annals of Emergency Medicine.
5 Interventions to Reduce Avoidable ER Use by the Medicaid Population looks at the collaborative effort among five regions of Ohio to target the key reasons for avoidable ER visits among Medicaid beneficiaries and roll out test interventions in a rapid cycle quality improvement approach.
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A Conversation With...
Joe Johnson, vice president of L.E.K. Consulting, notes that low scores on patient outcomes measures within the CMS Star Quality ratings program — metrics CMS weights most heavily in its assignment of stars — can typically be traced to poor provider and member engagement. Johnson suggests ways to enlist support from these two stakeholder groups, and describes how MA plans should prepare for the possible display in 2014 of CAHPS care coordination ratings along with with its star scores (though the care coordination ratings will not be factored into star ratings).
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Healthcare Questions & Answers...
How Do You Track Patients and Their Outcomes?This week's expert is Emily Brower, executive director of accountable care programs at Atrius Health.
Question: Given the number of different patient interventions that Atrius Health is using, how do you coordinate patient care and track individual patients and their outcomes?
Response: On the individual patient level, we use a high-risk roster review intervention. That's looking at the individual patient, bringing all the members of the team together. It's moving from a disease-based approach to a population-based approach, to try and get that whole patient perspective. And to develop one plan of care for the patient that all members of the team are on board with and the patient is engaged with. That’s the tracking at the individual patient level.
For outcomes at the broader population level, we use tracking tools such as a risk stratification tool and EPIC(R). We are also measuring cost, utilization and quality. We have cost utilization and quality metrics across all of our initiatives.
For more information on tracking patients and their outcomes, please visit: http://store.hin.com/product.asp?itemid=4602
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