Emergency rooms follow Medicaid savings plan

Emergency rooms follow Medicaid savings plan
YAKIMA, Wash. -- Hospitals across the state and here in the Valley are under pressure to improve communications as a way to save you money.

It's part of the plan in the new budget to reduce wasteful Medicaid spending in the emergency room. KIMA checked out what hospitals here in Yakima are doing to address the problem.

There are very few slow days in the emergency room at Yakima Valley Memorial Hospital. At times, doctors and nurses are under more strain than they need to be. Especially when patients come here for treatment that can easily be handled in a doctor's office.

"Going to the emergency department is obviously much more expensive than going to your primary care provider no matter who's paying for it," said Yakima Valley Memorial Hospital Emergency Room Nurse Manager Kim Bersing.

The big issue is when Medicaid patients do this. You pay for that. Memorial charges at least 800 dollars for emergency care. And, there are patients who do this repeatedly.

"I can tell you that there's people that have 10 visits in a month sometimes," Bersing said.

A patient like that costs $8,000 in a month. Memorial identified about 800 of these so-called "frequent flyers" in its system. Some are after prescription drugs. Some don't have any other doctor.

Yakima Regional Medical Center couldn't tell KIMA how many of its patients fit this classification, but recognizes the problem.

"Why is the person going from E.R. to E.R. in conjunction with the scripps or in conjunction with a medical diagnosis that really is not getting attended to," said Yakima Regional Medical Center Chief Nursing Officer Sara Williamson.

The state's taken notice after its most recent analysis showed Medicaid spending in emergency rooms reached $250 million in 2010.

Hospitals will be required to flag repeat E.R. patients and make the information easily available to every other hospital. Do these changes mean patients are in jeopardy of being turned away?"

"Absolutely not," Bersing said. "We are bound by federal law to triage people and to have a medical screening done."

Regional is in the process of ordering software to comply with the changes. Memorial already spent $30,000 on a new electronic sharing system and expects to have it installed by the fall.

The new plan pushes hospitals to let patients know when it's appropriate to go to the emergency room. They will also implement procedures to refer non-emergency cases to primary care doctors within three days.

These changes are scheduled to start taking effect on July first. The state hopes to save $31 million in Medicaid spending.