KHN Morning Briefing

Summaries of health policy coverage from major news organizations

Spotlight Turns To Patients Who Frequently Use Costly ER Services

Health policy experts examine the high costs incurred by people who frequently use costly emergency room services. The Washington Post reports on "'frequent fliers' -- people of modest means and poor health or patients who rely on emergency room care" and asks the question: "Are they part of the health care problem, or a result of it?"

The Washington Post features a Q&A with Dave Jamieson, author of wrote the cover story about such patients for the newspaper's magazine. Jamieson described how he found his subject for the piece: "I used to cover police and fire as something of a beat reporter in town. After a few ridealongs with firefighters, I was fascinated with frequent flyers--the fact that emergency responders were often picking up the same people, over and over. I started asking around about regulars, and Kenny's name often popped up, usually with a smile and a shake of the head. When I tracked him down, he was very kind and open with me about his life and his struggles" (Jamieson, 11/30).

Meanwhile, a doctor writes an essay in The New York Times suggesting incentives for doctors to prevent repeat hospital stays for patients: "A recent study in The New England Journal of Medicine found that one in five Medicare patients discharged from the hospital was readmitted within a month. One in three was readmitted within three months. Readmission is costly. In 2004, the cost to Medicare for unplanned readmissions was $17.4 billion - 17 percent of its total hospital budget. ... To curb the costs, Congress and the Obama administration are considering bonus payments to hospitals with low readmission rates and penalties on those with high rates. But these incentives are misdirected. Hospitals do not hospitalize patients; doctors do. And doctors currently stand to gain little from lowering readmissions. In fact, they will lose revenue. ... So I offer this prescription to Congress and the Obama administration: Share the savings, and you will see them grow" (Jauhar, 11/30).

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