Washington Reports An 'Unprecedented' Drop In Medicaid ER Visits

Mar 21, 2014

A year after hospitals began discouraging Medicaid patients from making unnecessary emergency room visits, the results are promising. A new state report shows the number of unnecessary visits to ERs in Washington fell by 10 percent last year.  

“A 10 percent reduction is almost unprecedented,” said Dr. Nathan Schlicher, an ER physician at St. Joseph’s Hospital in Tacoma.

The drop translates to more than $33 million in cost savings. For years Medicaid costs have been rising. In 2012 the state threatened to stop paying for ER visits considered non-critical.

Doctors and hospitals balked at the plan and sued. What followed was a compromise. Hospitals and ER physicians came up with strategies to lower ER use.

Schlicher worked with the state to change hospital practices and enforce the idea that emergency rooms are for emergencies. “To see this kind of result is encouraging and we hope to build upon them and can make some historic improvements,” he said.

Hospitals had to sign up for online tools so doctors could access patients’ medical records. This allowed them to see where patients have been for medical care, and what kind of drugs they’ve been prescribed. This was a way to screen for narcotics-seeking patients.

State representative Eileen Cody said she’s pleased with the success of those efforts. As a nurse, she looks forward to even more improvements. “I would say we’re always looking for more,” Cody said, “but we’re happy that we have met the saving assumptions that we first started out with.”

There are still ongoing challenges for the state Medicaid program. About 80 percent of high users of ERs have mental health issues and the next step is to better coordinate their care.