Last year a local hospital (Halifax Hospital in Daytona Beach) had 39 million dollars in ED (Emergency Department) charges that were unreimbursed. A large part of this expense is incurred by "frequent flyers" or patients with chronic conditions who are repeat visitors to the Emergency Departments because they do not have a regular doctor. Changes in Medicaid due to the Affordable Care Act have forced hospitals to look at these patients in a new and better way.
Instead of repeatedly treating the immediate problem as has happened in the past, hospitals are now looking at the situation with the goal of reducing ED visits. Creating a clinic for Medicaid patients with congesive heart failure is one step the hospital has taken. Where previously those patients had only the ED as a resource, now they are able to by-pass the more expensive emegency care for routine follow up in a clinic setting. Patients suffering from diabetes, substance abuve, skin infections, mental illness and chronic obstructive pulmonary disease are also referred to the clinic.
A team of nurses, social workers, dieticians, counselors, and student health coaches coordinate care for patients with limited financial resources. The goal is to provide health care guidance to patients outside of the emergency room setting which remains the most expensive provider of medical care.
"Other hospitals in Florida are doing the same. University of Florida Health Hospital's Care One Clinic in Gainesville implemented a clinic-based multidisciplinary team, after which ED visits fell from 4.9 to 3.8 per Care One "frequent flyer" patient, hospitalizations dropped from 3 to 2.1 and days spent in the hospital fell from 3.8 to 2.9, compared to the six months before the program."
It is not just the financial savings that makes this a worthwhile attempt at reducing costs. Targeting these "super-users" and creating clinic style resources where they are able to receive medical care and education about their disease provides a holistic approach that promises to improve their lives. Counseling does not just address their immediate medical need, but also housing, food, and lifestyle, things that are impossible to separate out from their general health.
Instead of repeatedly treating the immediate problem as has happened in the past, hospitals are now looking at the situation with the goal of reducing ED visits. Creating a clinic for Medicaid patients with congesive heart failure is one step the hospital has taken. Where previously those patients had only the ED as a resource, now they are able to by-pass the more expensive emegency care for routine follow up in a clinic setting. Patients suffering from diabetes, substance abuve, skin infections, mental illness and chronic obstructive pulmonary disease are also referred to the clinic.
A team of nurses, social workers, dieticians, counselors, and student health coaches coordinate care for patients with limited financial resources. The goal is to provide health care guidance to patients outside of the emergency room setting which remains the most expensive provider of medical care.
"Other hospitals in Florida are doing the same. University of Florida Health Hospital's Care One Clinic in Gainesville implemented a clinic-based multidisciplinary team, after which ED visits fell from 4.9 to 3.8 per Care One "frequent flyer" patient, hospitalizations dropped from 3 to 2.1 and days spent in the hospital fell from 3.8 to 2.9, compared to the six months before the program."
It is not just the financial savings that makes this a worthwhile attempt at reducing costs. Targeting these "super-users" and creating clinic style resources where they are able to receive medical care and education about their disease provides a holistic approach that promises to improve their lives. Counseling does not just address their immediate medical need, but also housing, food, and lifestyle, things that are impossible to separate out from their general health.
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