title: Under the gun to act, hospitals in Washington state put their hopes on seven "best practices" to curb non-emergent use of their EDs by Medicaid patients.
abstract: Hospitals in Washington state are under intense pressure by their state legislature to reduce the non-emergent use of EDs by Medicaid patients. As a result, emergency physicians and the Washington State Hospital Association have put together a plan involving the implementation of seven best practices aimed at educating patients about using the most appropriate setting for their care needs, electronically sharing information across ED sites so that narcotic-seeking patients can be easily identified, and expanding access to primary care resources. The hospitals have pledged to show progress by January of 2013 under the threat that legislators may move to limit the number of non-emergent ED visits that Medicaid patients can have. One aspect of the effort involves the creation of a Patient Review and Coordination Program, so that frequent ED utilizers can be identified and tracked wherever they present for care. The Washington State Hospital Association is meeting with each of the Medicaid plans in the state to encourage them to establish strong call centers and to reassess the scripting used so that patients are appropriately advised about where to seek care for their complaints. Lack of funding for mental health care in Washington state remains an obstacle, as an estimated 85% of high ED utilizers have concurrent mental illness.
mesh_terms: D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D006297:Health Services Accessibility; D006300:Health Services Misuse; D008484:Medicaid; D010818:Practice Patterns, Physicians' / Q000592:standards*; D014481:United States; D014861:Washington