Hospitals Take Various Steps in Hopes of Decreasing "ER Frequent Fliers"

As the bill for providing healthcare in the United States continues to grow, hospitals are finding that many of their expenses can be chalked up to patients with chronic illnesses such as diabetes and heart failure taking avoidable trips to the emergency room (ER). Take for example that Halifax Health and Florida Hospital, both in the Daytona Beach, Florida area, spent a combined $39.2 million in 2013 alone on uncompensated care, most of which was sent through commercial insurance companies that raised prices for subsidized care for uninsured patients.

Local hospitals reported that most of these patients—who are known as “ER frequent fliers”—could benefit from better forms of care at lower costs if they are consistent and engaged in their own care plan.

Despite hospital programs that help patients with their medications in the hopes of preventing additional ER visits, many of the frequent fliers are either mentally ill and choose not to take their medication, are drug addicts who return with reoccurring problems, or are patients who can’t afford their prescriptions and are unable to make appointments with their primary care doctors in a timely manner. The report read that these patients make up 4.5% to 8% of all ER patients and constitute 21% to 28% of all ER visits.

Paul Mucciolo, MD, Halifax Sports Medicine, said that the ER is not the best place to come if the patient is seeking treatment. Instead, the chronically ill would benefit from a full time doctor who could manage their care more closely. “A lot of what I do is band-aids. I don't cure a lot of things,” Dr Mucciolo said.

According to 1 report, hospitals are beginning to implement primary care and specialized clinics to provide additional help and resources for patients in need. Additionally, hospitals are hiring health coaches to guide patients through the healthcare system and connect with primary care physicians. By doing so, the hospitals hope to decrease ER visits by encouraging patients to take their medications regularly, exercise, and follow their doctor’s advice.

Because congestive heart failure cases are a main driver of ER visits, Halifax Health recently opened a clinic that provides follow-up care in an attempt to combat the rising number of avoidable hospital visits. Residents in the Halifax Health tax district can also participate in its district’s patient assistance programs and obtain their medication for a co-pay of only $7.

Florida Hospital took another approach: partnering with Bethune-Cookman University, the hospital puts together a team of clinicians for patients battling chronic illness as a means to organize postdischarge care.

While patients who do come to the ER for serious health conditions will never be turned away, these newly implemented programs and services may help to decrease the number of ER visits by making additional care more readily accessible for patients in need.

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Hospitals Look for Ways to ground ER 'Frequent Fliers' [News Journal Online]