Emergency Department Super Utilizer Programs

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Emergency Department Super Utilizer Programs - OPEN MINDS

CenterforRuralHealthPolicyAnalysis

EmergencyDepartmentSuperUtilizerPrograms

Rural

A.ClintonMacKinney,MD,MS

CooperativeAgreementfundedbythe

FederalOfficeofRuralHealthPolicy:

UB7RH25011Ͳ01Onthego?UsetheadjacentQR

code withyoursmartphoneortabletto viewtheRHSATAwebsite.Fivepercent visitsintheUnitedStates. coordination andsocialserviceassistance). 2

SUMMARY

provider,attherighttime - orattherightprice.TypicalSUhealthconcernsofchronicdiseaseandlow acuitytend programs, describesSUprogramdesi gn, operatingSUprograms(casestudies). 3

EMERGENCYDEPARTMENTSUPERUTILIZERS

A 1

Emergencydepartment

2 3 byasmallpercentage A patientwhodisproporti o natelyutilizesEDservicesisconsidereda"superutilizer"(SU).Although terventions andprimary care." 4

70%ofvisitswereoneveningornightshifts.

2 associated 2,5 TheSU theyrequireimmediatemedicalattention. 2,6 insured throughMedicaidthanbyprivateinsurance. 7 5,8

Superutilizersalso

problems.

9Ͳ11

Thus,SUstendtocontinueto

top10%intwosubsequentyears. 12 4 SUPER

UTILIZERPROGRAMS

clinical services, clinical 13

TheEDisgenerallythe

officeandinthecommunity. beenimpl 14 hospital assessment.

1.EstablishSUprogramgoals.

reducing hospitalcostsassociatedwithSUs.

2.Definedatare

quiredtoassesstheSUprogram.

4.DefineanSU.

TheSUprogra

identifySUsamongallEDpatients.

5.DevelopanSUprogrambusinessplan.

New plantoprojectprogramcostsandsavings.

6.Establishamultidisciplinarycareteam.

necessaryforeffectiveintervention.

7.Collaboratewithcommunityresources.

servicesandcompet encies.

9.StartwithasmallnumberofSUs.

A improvement.

10.AssessSUprogramoutcomes.

SUPER

UTILIZERPROGRAMDESIGN

parentheses)mayinclude:

DecreasedEDvisits(EDvisitsperSU)

Decreasedho

Increasedhospitalrevenue(e

sources) SU) 15 ndontheprogram'sSUdefinitionandthedata carrier, information maybesignific payment

6 ElectronicHealthRecord(EHR)-AwellͲdevelopedEHRwillcontaincompleteclinicalcaredata

parameters functional EHR. fixed andvariablecoststoauniqueEDvi s itorassociatedancillaryservices.However,toassess necessary. qualityandefficiencyofcare. 16 healthcareproviders. 17 discussed ngaging currenthospitalresources, utilization. implementation revenue, healthdataarerequired. ofSUcriteriainclude:

Emergencyd

visitsperyeartofivevisitspermonth)

2,5,6,18Ͳ22

AcombinationofEDandi

npatient year) 4,23

Patientswhoaccount

utilizers)

4,5,11

Thetop10EDutilizers

PatientswhoEDpersonnelhaveidentifiedas

SUs 5 SUPER

UTILIZERINTERVENTION

ED/inpatient

interven necessarily management, individualizedcareplans,patiente ducation, primarycarepartnerships,healthcoaching, andmanagedcarelevelinterventions. 19 available preferably anddevelopsamultidis ciplinaryinterventioncareplan. outcomes." 25
services, 22,26

Otherinterventionsinclude

6 goals, interview, transportationorsubstan ce suchasgrocer y 27
Ifa 10, 24
range serviceorgan izations,andcommunityworkers. 18

[PDF] Emergency Department Super Utilizer Programs - OPEN MINDS

NHS BLOOD AND TRANSPLANT RETRIEVAL ADVISORY GROUP SUPER

Policy - Microsoft

Emergency Department Super Utilizer Programs - OPEN MINDS

Simon Bean --- Super Urgent - Anna von Reitz

Original Article DOI: 1022374/jeleuv3i3101 THE “SUPER

Searches related to SUPER TROP URGENT filetype:pdf