Collaborative program helps reduce overuse of emergency services

A collaborative health program between medical and community service groups launched by the Northwest Physicians Network (NPN), a part of DaVita Medical Group, in Pierce County, Washington, has led to a 44% reduction in 911 calls, a 47% reduction in ambulance transports, and a 36% reduction in emergency department visits within the first two years of the program. In addition, hospital admissions were reduced by 43% and observational stays by 31% during that time.

Prior to the program’s inception, Pierce County would routinely see thousands of 911 calls requesting emergency response services every year, but emergency responders found that while some of these calls were for true emergencies, many of these patients required additional long-term care for chronic or complex illnesses rather than just basic emergency medical care, according to a press release from DaVita. These calls overburdened emergency resources, and patients weren’t getting the long-term care they needed.

In 2014, NPN collaborated with six Pierce Country fire districts and other local medical and community groups on a program in which the fire districts referred patients who called 911 more than twice in two months and more than five times in five months to NPN. From there, NPN would refer the individual to case management services connected to the individual’s primary care provider, behavioral health provider, or payor group. In some cases, other community resources, such as wellness programs and social services, were brought in to meet with patients to form plans on how to address their specific healthcare needs.

NPN worked with Qualis Health, a population health care consulting organization, to evaluate the success of the program. Qualis Health tracked 184 patients who were referred through the program, had Medicare, and were alive at least 12 months after the referral. In addition to reductions in emergency service use and admissions, Qualis Health noted that more than half of the patients experienced improved health outcomes.

With fewer emergency department visits and improved patient outcomes, Qualis Health also estimated a savings of $7.38 million for the 184 Medicare patients on hospital visits alone.