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Reducing Avoidable ER Visits. Jackie Huck Community Health Network of Washington. History. Community Health Plan(CHP) of Washington was formed in 1992 by 19 community and migrant health centers throughout the state of Washington

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reducing avoidable er visits

Reducing Avoidable ER Visits

Jackie Huck

Community Health Network of Washington

  • Community Health Plan(CHP) of Washington was formed in 1992 by 19 community and migrant health centers throughout the state of Washington
  • CHP serves as the safety net for low-income and disadvantaged communities
  • Our Community Health Centers are the front line, providing essential medical and behavioral-health care within their communities
  • CHP operates from the core belief that increasing the access to health care translates into healthy families and strong communities
products enrollment

Through Medicaid, state-sponsored, and Medicare programs CHP offers some type of medical care product in all 39 counties in Washington State, serving more than 275,000 members and more than 20%of the Medicaid population.

The Network serves close to 40% of the of the Medicaid population

economic impact
Economic Impact
  • CHP with its CHCs act as significant employers and make significant economic contributions to their communities
  • The Network now serves over 700,000 unique patients in Washington state per year…more than 10% of the entire pop of the state.
enrollee er visits
Enrollee ER Visits
  • Increasing number of ER visits each year
  • Fairly high percentage of “avoidable” visits based on MediCal criteria
data requirements chp chnw
Data Requirements CHP & CHNW
  • Patient Name
  • DOB and current contact information
  • Admit/discharge dates for inpatients
  • ER visit date
  • Attending physician
  • Follow-up care plan/discharge instructions
  • For CHP enrollees- the member number
  • Diagnosis
chp initiatives
CHP Initiatives
  • Case management
  • 24/7 Nurse Advice Line available to all enrollees and clinic patients
  • Continuity and Coordination of Care
  • Patient-centric education regarding appropriate ER use and establishing and maintaining Health Care Home
chnw initiatives
CHNW Initiatives
  • Developing community partnerships
  • Patient-centric education and outreach
  • Health Literacy: group classes and one-on-one education with families/caregivers
  • Identification and spread of best practices
  • Strengthened work towards moving to patient-centered health care homes
  • Improving access and developing a culture of performance excellence
2010 quality grant
2010 Quality Grant

Focus: reduction in ER utilization

Success Stories

  • Providence Everett and Providence Centralia partnership with local CHCs
  • Lowest level of total ER visits in three years despite ongoing upward trend nationally
2010 quality grant1
2010 Quality Grant

Lessons Learned/Barriers

  • CHCs need timely actionable data from hospitals
  • Developing partnerships not easy, but is essential
  • Sharing best practices strategies important
  • Cultural and linguistic considerations for developing educational materials
desired outcomes
Desired Outcomes
  • Improving overall quality and coordination of care, while reducing costs
  • Accurate and timely admission notification
  • 24 hour turn-around notification of patients seen in ER sent to CHC for all clinic patients
  • ER utilization reports to plan for all enrolled CHP members
how hospitals can help
How hospitals can help
  • Work closely with safety-net clinics in their area to help patients get assigned to a medical home
  • Also a need to have hospitals work as partners to develop programs providing alternatives to patients coming to the ER without emergent care needs
questions and comments
Questions and Comments
  • Jackie Huck

Network Quality Program Director Community Health Network of Washington

jackie.huck@chnwa.or g