Former White House Advisor Touts Cure for Reducing ER Visits

Ezekiel Emanuel knows health care. He’s a former White House Advisor, an oncologist, a vice provost at the University of Pennsylvania, and the author of “Reinventing American Health Care.” And he has a way to help solve the rising increase in emergency room (ER) use. This is good news for employers, who rank hospitalization—including ER visits—as the number one driver of company health care costs.

In an op-ed piece for the New York Times, Dr. Emanuel notes that one of the big selling points of health care reform was that the expansion of health care coverage would increase Americans’ access to preventive and primary care. And decrease the unnecessary use of emergency rooms, saving billions of dollars.

A prescription for reducing ER visits

However, a new survey by the American College of Emergency Physicians found that 75 percent of emergency doctors reported increases in patient volume since the Affordable Care Act (ACA) went into effect. Opponents of ACA point to these increases as proof positive of the law’s failure. But Dr. Emanuel counters by saying that the emergency room problem isn’t unsolvable, just that insurance coverage alone is insufficient.

He then goes on to point out that a partnership between Group Health (now Kaiser Permanente) and SEIU Healthcare NW Health Benefits Trust seems to have found a solution. SEIU, which delivers health benefits to thousands of health care workers, has reduced ER use among a subset of the trust’s membership by 27 percent over four years.

The proof is in the savings

By adopting a four-pronged strategy, Group Health and SEIU worked together to augment the trust’s health care benefits with a wellness plan, including:

  • A cash incentive if workers complete four progressive wellness steps, including completing an online “health risk assessment.”
  • Increasing the copay for an ER visit to $200, while the out-of-pocket charge for an urgent care visit remained at just $15.
  • Introducing a “Care Begins with You” social media campaign to educate staff about when to use the emergency room.
  • Reminding workers of the locations and hours of urgent care centers and other appropriate, lower-cost care.

By persistently educating patients, the program helped them to navigate the health care system. The result? Workers have avoided nearly 1,200 unnecessary ER visits each year from 2010 to 2013.

It’s not neurosurgery

As Dr. Emanuel says, “…This strategy is not neurosurgery. It is a relatively simple set of interventions that could easily spread to almost every other employer and insurer.” It’s also a way to help us all save billions of dollars.