Seven states and the National Governors Association are teaming up to find ways to save money and better coordinate the care of Medicaid and uninsured patients who frequently use hospital emergency rooms and other costly health services.
“There’s a handful of people who drive most of our spending,” said Dan Crippen, the executive director of the National Governors Association. These patients, called “super-utilizers” or “frequent flyers,” often go to a hospital to get treated for a recurring health issue that can be treated more effectively in other ways, he said.
Connecting these patients with community services can bring down costs in the long run.
“It’s not just physical health services,” Crippen said. “There are a lot of non-physical health services that can help these folks out.”
These patients make up 5 to 10 percent of hospital patients, according to Crippen.
States leaders will first meet as a group — then officials will spend 18 months implementing the plans in their communities. Alaska, Colorado, Kentucky, New Mexico, Puerto Rico, West Virginia and Wisconsin are the states participating in the project.
Officials from each of those states will work with the association and national health care experts to develop a plan that will redirect these patients to care that is less costly, more efficient and more accessible. The effort will also explore non-medical issues that these patients often confront, such as transportation and housing problems. For example, Crippen noted, asthma patients may be able to control their condition and avoid costly trips to the doctor or the hospital if they have an air conditioning unit at home, but often state programs don’t have the authority to spend money on such non-medical interventions.
Additionally, patients who are given prescriptions sometimes don’t fill them because they don’t have transportation to a pharmacy, Crippen said. By coordinating delivery or mail-order prescriptions, he added, experts say individuals will have to visit ERs less often.
“Our current health care system doesn’t pay for those as health care costs,” Crippen said, and this effort by the states would seek to find ways to solve a patient’s multiple issues at one time.