Jennifer Wiler, vice chair and associate professor of emergency medicine, was a panelist earlier this month at a Brookings Institution MEDtalk event, “Reimagining emergency medicine: How to integrate care for the acutely ill and injured.” The discussion focused on improving patient education and care coordination. (Wiler’s comments begin at about the 38-minute mark.) The University of Colorado School of Medicine, the University of Colorado Hospital and other partners have a program called Bridges to Care, testing a model that aims to decrease use of emergency departments for care that could be provided in a primary care setting.
Wiler said the point of the program is to educate and empower patients about the most appropriate place to get the care they need. So far, the program has been very successful, with 550 patients enrolled since 2012. Six months after a Bridges to Care intervention, about 90 percent of the patients seek primary care services, rather than emergency department/inpatient care, for their health care needs. She also said that this assistance helps reduce emergency department and inpatient visits by these patients and showed a $2 million cost savings to the healthcare system.
In a separate report, Roberta Capp, assistant professor of emergency medicine, provided additional context about why it’s so important to address the behavior of patients who are frequent users of hospital emergency departments. In an article published last week in the journal “Medical Care,” Capp reported that more than half of all Medicaid enrollees prefer the “one-stop shop” of a hospital emergency department. The finding points to a need for services that can help these patients find the most cost-effective and suitable care for their healthcare needs. Solutions may include services like community health workers and case managers, based in emergency departments, to help the patients navigate the health care system. “This type of work brings great value to Medicaid,” Roberta and her co-authors write, “and potentially the healthcare system, as it will likely improve primary care utilization for chronic disease management and preventive services.”