GAO looks at ways to reduce, divert ED use

Three strategies--focusing on emergency department (ED) diversion, care coordination and accessibility of services--could help reduce ED use, according to a new Government Accountability Office (GAO) report.

GAO interviewed officials from nine health centers, and conducted group interviews with officials from multiple health centers operating in three states about their strategies. The findings were released today by GAO's director of healthcare, Debra Draper, at Senate subcommittee hearing on diverting nonurgent ED use.

Some health centers collaborated with hospitals to divert emergency department patients by educating them on the appropriate use of the ED--and the services offered at the health centers, the report said. Also, by improving care coordination for patients, health centers may help reduce ED visits by encouraging patients to first seek care at a health center and then reducing--if not preventing--disease-related emergencies from occurring.

Also, the health centers used various tactics to increase the accessibility of their services--such as offering evening and weekend hours and providing same-day or walk-in appointments. This helped position the health center as a "convenient and viable alternative" to the ED, GAO noted.

Health center officials told GAO that they experienced several challenges in implementing strategies that could help reduce ED use. For example, some officials indicated that various services--such as those provided by case managers who may help coordinate care--generally are not reimbursed by third-party payers.

For more information:
- read the GAO report (.pdf)
- view the Senate Primary Health and Aging Subcommittee hearing on diverting nonurgent ED use