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April 7, 2014

Data Sharing Provides Rx for Cutting ER Costs

George Leopold

A two-year-old data-sharing initiative mandated by the State of Washington aimed at reducing healthcare costs has yielded a 10 percent decline in the number of unnecessary emergency room visits by Medicaid recipients.

According to a recent report to the Washington legislature, the state’s Emergency Department Information Exchange has so far resulted in a 9.9 percent decline in ER visits by Medicaid patients. Based on results collected in the initiative’s first year, the Washington State Health Care Authority also reported a 24 percent drop in the number of narcotics prescriptions for Medicaid beneficiaries as the exchange provides more visibility into when prescriptions are being filled.

Source: Washington State Health Care Authority

Overall, the data-sharing effort partially contributed to a $33.7 million reduction in state Medicaid ER costs.

Proponents of the initiative added that the information exchange helped create an entirely new set of data that hospitals could use to determine which patients return to ERs.

The state-mandated information exchange required all state hospitals with emergency departments serving Medicaid patients to sign on to the effort by July 2012. The goal was to reduce unnecessary ER visits by identifying frequent users, then share information about their care.

The information exchange allowed ER physicians to view data on patients’ visits to all state hospital on the exchange over the previous year. One focus was to identify patients with chronic illnesses or who were seeking narcotics.

The exchange included a Prescription Monitoring Program database used to collect data on patients being prescribed controlled substances. The database allows physicians and pharmacists to see filled prescriptions. Data on previously filled prescriptions “is essential information to reduce the number of patients seeking narcotics,” noted the report, which was released in March.

The state healthcare authority also reported that 98 state hospitals are sharing ER usage data on the information exchange. The program’s breadth has been credited with providing physicians with greater access to patient information, thereby improving their ability to provide appropriate care.

Participating hospitals also have developed a standard format for delivering emergency care. The care plan is available via the exchange to a network of 97 ERs across the state, the report noted.

While adoption of the exchange’s best practices was cited as a key factor in reducing ER costs, the report noted that the transition from fee-for-service plans to managed care organizations under the Affordable Care Act, widely know as “Obamacare,” also contributed to the reduction in ER costs.

Washington is widely credited with having one of top state health insurance exchanges in the nation under the new federal healthcare law.

Based on the early success of the information exchange in reducing unnecessary ER visits, state officials said they want to expand the information exchange to include “new data linkages” such as incorporating prescription monitoring into the hospital information exchange. They also are promoting electronic patient care plans throughout the Medicaid IT system to bring primary care physicians into the information exchange. The health information initiative also could be extended to home healthcare, the report concluded.

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