Agency tries to help get a grip on ER ‘frequent utilizers’

From the Telegram:

Sometimes known as “frequent utilizers,” or more derisively as “frequent fliers,” adults such as Mr. Adkins who repeatedly visit hospital emergency rooms are one of the tough problems facing Massachusetts hospitals as pressure mounts to contain medical spending. The state estimated in 2010 that people visiting emergency rooms five or more times per year made up 4 percent of all emergency-room patients but accounted for 20 percent of all visits to emergency rooms. Nearly half of the $1.24 billion in hospital emergency department costs in 2010 were preventable or avoidable, according to the state.

Frequent visits to hospital emergency departments do not necessarily help patients, either. Many suffer from multiple medical, behavioral and addiction ailments that emergency departments — which aim to stabilize patients who need urgent care — are not in the best position to address.

As insurers move to new ways of paying for patient care, particularly “global payments” that ask providers to take care of all a patient’s needs, hospitals could have an incentive to address frequent users, according to Kate Nordahl, director of the Massachusetts Medicaid Policy Institute at the Blue Cross Blue Shield of Massachusetts Foundation.