Bending the Health Care Cost
Curve
Community Collaboration for Appropriate
Emergency Department Care
Community Health Association of Spokane
&
Holy Family Hospital
Program Information
►
CHAS partners with Providence Holy Family Hospital to
reduce non-emergent Emergency Department (ED)
visits by Medicaid patients.
►
CHAS created a specific position, ED Liaison, who’s
primary function is facilitation of a “warm handoff”
from the ED to a medical home.
►
Patients are identified as they are discharged from the
ED and are given the ED Liaison cell phone number to
call for a priority follow up appointment.
Successes:
► The
program continues to provide needed
appointments to patients who are dependent on
the ED for issues that are better handled in a
primary care setting.
► From
January, 2010, through CHAS has been able
to provide primary care visits to approximately 600
individual patients coming out of the ER. This
includes establishing care for more than 250 NEW
patients.
Successes Continued
► Using
a sample of 19 patients who have
entered our ED diversion program, we have
been able to reduce annualized ED visits an
average of approximately 50%.
► ED
physicians and staff were some of the
program’s biggest advocates once they
realized the value it was to the patients.
Challenges
► There
was a longer than anticipated
implementation phase.
► There
is very little incentive for patients to use
their PCP instead of the ED, ie. No co-pays for
Medicaid patients.
► Extremely
challenging case loads of patients
who have co-morbidities that can include
mental illness, chronic pain, and substance
abuse.
Challenges Continued
► Lack
of patient health data integration
across community delivery systems invites
duplication and inaccurate information.
► Staff
turnover at both the FQHC and the
hospital created breakdowns in
communication and on processes which
were critical to the program.
Lessons Learned
► The
first step in implementing this type of a
program is developing a good working
relationship between the FQHC and the
hospital.
► Getting
front-line staff aware and involved
with the program is critical in the beginning.
Presenter Contact Information
John Browne
Director of Operations
Community Health Association of Spokane
Ph: 509-444-8888
jbrowne@chas.org