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Community Health Association of Spokane & Holy Family Hospital

Bending the Health Care Cost Curve Community Collaboration for Appropriate Emergency Department Care. Community Health Association of Spokane & Holy Family Hospital. Program Information.

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Community Health Association of Spokane & Holy Family Hospital

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  1. Bending the Health Care Cost CurveCommunity Collaboration for Appropriate Emergency Department Care Community Health Association of Spokane & Holy Family Hospital

  2. Program Information • CHAS partners with Providence Holy Family Hospital to reduce non-emergent Emergency Department (ED) visits by Medicaid patients. • CHAS created a specific position, ED Liaison, who’s primary function is facilitation of a “warm handoff” from the ED to a medical home. • Patients are identified as they are discharged from the ED and are given the ED Liaison cell phone number to call for a priority follow up appointment.

  3. Successes: • The program continues to provide needed appointments to patients who are dependent on the ED for issues that are better handled in a primary care setting. • From January, 2010, through CHAS has been able to provide primary care visits to approximately 600 individual patients coming out of the ER. This includes establishing care for more than 250 NEW patients.

  4. Successes Continued • Using a sample of 19 patients who have entered our ED diversion program, we have been able to reduce annualized ED visits an average of approximately 50%. • ED physicians and staff were some of the program’s biggest advocates once they realized the value it was to the patients.

  5. Challenges • There was a longer than anticipated implementation phase. • There is very little incentive for patients to use their PCP instead of the ED, ie. No co-pays for Medicaid patients. • Extremely challenging case loads of patients who have co-morbidities that can include mental illness, chronic pain, and substance abuse.

  6. Challenges Continued • Lack of patient health data integration across community delivery systems invites duplication and inaccurate information. • Staff turnover at both the FQHC and the hospital created breakdowns in communication and on processes which were critical to the program.

  7. Lessons Learned • The first step in implementing this type of a program is developing a good working relationship between the FQHC and the hospital. • Getting front-line staff aware and involved with the program is critical in the beginning.

  8. Presenter Contact Information John Browne Director of Operations Community Health Association of Spokane Ph: 509-444-8888jbrowne@chas.org

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