Traverse City Record-Eagle

Other Views

December 29, 2011

Other View: Right use of ER saves money

The Oakland Press ----

Earlier this year,

we pointed out

that insurance

companies and medical

providers already have

some knowledge about

how to cut health-care

costs. The question is

whether they have the

will to put the knowledge

to use.

We saw an encouraging

sign the other day in a

report from Grand Rapids.

In that city, Spectrum

Health identified more

than 900 people who

depend far too much on

getting routine medical

care at the hospital’s

emergency room.

A facility designed

and staffed for treating

life-threatening emergencies

is a poor source for

routine care. The care

may be excellent, even at

times after a long wait.

But it stresses the staff

and facility to provide

non-emergency care. The

care doesn’t treat the

whole patient and indeed

may miss something important.

All of the people contacted

had visited the

emergency room at least

10 times in a year, and one

had gone to the ER 226

times.

The solution? Spectrum

is calling the patients,

diverting them to the new

Medical Group Center for

Integrative Medicine.

The report noted that

although many have

mental, substance abuse

or chronic health issues,

almost all are covered

by Medicare or Medicaid.

The new center will

provide an hour each with

a case manager and a doctor.

Both, we assume, will

discuss all of the issues

that have an impact on

health.

Does it work?

We’re certain that it

does.

A pilot program three

years ago led to a dramatic

drop in ER visits

and a major savings. The

new program, according

to the report, could save

as much as $15 million

a year for Spectrum, at

least 10 times that much

on statewide Medicaid

payouts if adopted statewide.

...

We commented earlier

on a 2010 article in the

New Yorker magazine

that described a similar

program in New Jersey

with similar results.

Among the results: A

visit with a physician in

an office setting found

problems an ER physician

might miss. In New

Jersey, a woman in her

20s was suffering from

severe migraines. Her ER

costs had topped $50,000.

The medication from the

ER she’d been taking had

done her no good.

So we’re convinced that

Spectrum has the right

idea.

Who’s following suit in

our state?

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