Reducing Avoidable ER Visits

1
Reducing Avoidable ER Visits

• Jackie Huck
• Community Health Network of Washington

2
History

• Community Health Plan(CHP) of Washington was
  formed in 1992 by 19 community and migrant health
  centers throughout the state of Washington
• CHP serves as the safety net for low-income and
  disadvantaged communities
• Our Community Health Centers are the front line,
  providing essential medical and behavioral-health
  care within their communities
• CHP operates from the core belief that increasing
  the access to health care translates into healthy
  families and strong communities

3
Products/Enrollment

• Through Medicaid, state-sponsored, and
  Medicare programs CHP offers some type of medical
  care product in all 39 counties in Washington
  State, serving more than 275,000 members and more
  than 20 of the Medicaid population.
• The Network serves close to 40 of the of the
  Medicaid population

4
Economic Impact

• CHP with its CHCs act as significant employers
  and make significant economic contributions to
  their communities
• The Network now serves over 700,000 unique
  patients in Washington state per yearmore than
  10 of the entire pop of the state.

5
Enrollee ER Visits

• Increasing number of ER visits each year
• Fairly high percentage of avoidable visits
  based on MediCal criteria

6
Data Requirements CHP CHNW

• Patient Name
• DOB and current contact information
• Admit/discharge dates for inpatients
• ER visit date
• Attending physician
• Follow-up care plan/discharge instructions
• For CHP enrollees- the member number
• Diagnosis

7
CHP Initiatives

• Case management
• 24/7 Nurse Advice Line available to all enrollees
  and clinic patients
• Continuity and Coordination of Care
• Patient-centric education regarding appropriate
  ER use and establishing and maintaining Health
  Care Home

8
CHNW Initiatives

• Developing community partnerships
• Patient-centric education and outreach
• Health Literacy group classes and one-on-one
  education with families/caregivers
• Identification and spread of best practices
• Strengthened work towards moving to
  patient-centered health care homes
• Improving access and developing a culture of
  performance excellence

9
2010 Quality Grant

• Focus reduction in ER utilization
• Success Stories
• Providence Everett and Providence Centralia
  partnership with local CHCs
• Lowest level of total ER visits in three years
  despite ongoing upward trend nationally

10
2010 Quality Grant

• Lessons Learned/Barriers
• CHCs need timely actionable data from hospitals
• Developing partnerships not easy, but is
  essential
• Sharing best practices strategies important
• Cultural and linguistic considerations for
  developing educational materials

11
Desired Outcomes

• Improving overall quality and coordination of
  care, while reducing costs
• Accurate and timely admission notification
• 24 hour turn-around notification of patients seen
  in ER sent to CHC for all clinic patients
• ER utilization reports to plan for all enrolled
  CHP members

12
How hospitals can help

• Work closely with safety-net clinics in their
  area to help patients get assigned to a medical
  home
• Also a need to have hospitals work as partners to
  develop programs providing alternatives to
  patients coming to the ER without emergent care
  needs

13
Questions and Comments

• Jackie Huck
• Network Quality Program Director Community
  Health Network of Washington
• jackie.huck_at_chnwa.or g
• 206-613-8937