Kaiser Targets Preventable ED Visits

Monday, June 28th, 2010
This post was written by Melanie Matthews

Over the course of the last 18 months, Kaiser Permanente in Colorado has taken a very hard look at its ED utilization across its population, according to Sara Gray, senior manager of emergency services at Kaiser Foundation Health Plan of Colorado.

Kaiser found that avoidable and unnecessary emergency department visits accounted for upwards of 20 percent of its approximately 72,000 ED visits per year, which is not an insignificant amount of time and energy and resources being spent on things that may be better treated in other locations, she added.

Additionally like many health plans, Kaiser was experiencing sharply rising costs for ED visits, both as a health plan, as well as for its members in terms of what their cost share is. And finally, Kaiser has a subset of its population who excessively uses the emergency department.

Gray shared with participants in last week’s webinar Reducing Unnecessary Emergency Room Visits: Strategies To Discourage Inappropriate Use and Reduce Preventable Visits, the steps that Kaiser is taking to mitigate unnecessary and preventable emergency room visits, including a look at how a data review can identify potential areas to address, strategies to get members to appropriate care, the top 15 ICD-9 codes to target and how narcotic contracts can decrease the number of visits by chemical dependency patients.  Hear more details on Kaiser’s program in an online interview with Gray at: http://www.hin.com/podcasts/podcast.htm#119

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