'Frequent flyer' ER visits drop with coordinated care

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Oregon's innovative program to keep "frequent flyer" patients out of hospital emergency rooms is seeing early signs of success, according to Kaiser Health News. The program not only offers frequent ER visitors access to preventive care services, it also provides ancillary services, even giving one congestive heart failure patient new shoes, a new sleeping bag and placing him in adult foster care.

As part of the nation's healthcare overhaul, Kaiser Health News reports Oregon's new coordinated care organizations (CCO) are testing out new practices, such as trying to reduce Medicaid costs by encouraging patients who frequently turn up at hospitals emergency rooms to turn to their regular doctors for care instead.

Oregon has no formal numbers yet, the article states, but the state has received almost $2 billion in federal funds and five years to show it can reduce the rate of medical inflation by 2 percent. However, there are early indications that the program is making a difference.

According to the Oregon.gov website, the state is targeting frequent flyers who visit hospital ERs at least 10 times a year, and in some cases, as often as once a week. Health experts say these frequent flyers help explain why 80 percent of the nation's healthcare costs are spent on 20 percent of the population, The Daily Astorian reports.

Since the program began in July 2012, Oregon.gov says St. Charles Medical Center has seen emergency room visits by 144 frequent users in the Bend area drop by 49 percent during the first six months of the year. "That's 541 fewer ER visits by that group alone, reducing costs by an average of more than $3,100 per patient," the website states.

And Kaiser Health reports 40-year-old Jeremie Seals is someone who can attest to the benefits of the program. At the age of 35, he had a heart attack and now suffers from congestive heart failure. "I basically lived at the emergency department," he told Kaiser Health.  "Ever since I'd had a heart attack, anytime my chest hurt, I'd either call the ambulance or go up to the hospital and I think it was also out of desperation to just get out of my car and off the street."

In fact, in 2011 he visited the emergency department at Oregon Health & Science University in Portland 15 times and was admitted to the hospital 11 times. But through the program's intervention, he only showed up at the ER four times in 2012 and had three inpatient admissions, The Daily Astorian reports.

CareOregon, one of the organizations under the Health Share Oregon CCO, hasn't released the specific amount it costs to care for patients like Seals, but Rebecca Ramsey, director of community care at CareOregon, told the Daily Astorian there are significant savings even taking into account the $3,500 it costs to have an outreach worker for Health Share Oregon work with Seals..

Ramsey says just one inpatient admission for someone with Seals' medical problems can easily amount to $10 thousand, $20 thousand, even $30 thousand--depending on the length of the stay.

To learn more:
- here's the Kaiser article
- read the Daily Astorian report
-  check out the Oregon.gov website

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