Written by Frank Tucker
Approximately 20% of the emergency medical system (911) use comes from frequent users often linked to chronic care health issues. Accounting for less than 1% of the population of the city, they disproportionately drive tax payer ambulance, fire fighter and paramedic costs. Prehospital case management may reduceEMS use in high-frequency EMS users and create significant cost savings to the City and the health care system. They not only help save money, they help save lives. Not only can case management help the patient, it can help free valuableEMS resources needed for an already burdened system. Case Managers will:
- Help enroll individuals in health insurance
- Connect individuals to a medical home
- Provide health education and information to avoid crises
- Link individuals to a variety of other services, including disease case management programs, food pantries, housing, employment, and homeless shelters.
By using case managers, we change the entry point to the health care system of frequent users from EMS to coordinated health care. A key component to effectively managing these cases is Case Management Software that takes a patient relationship paradigm similar to customer relationship management in business. Using a medical case management system like MicroHealth Case Manager can help bring efficiency and cost-effectiveness to your City. HIPAA-compliant Medical Case Manager solutions like MicroHealth Case Manager facilitates the collaborative process to help manage treatment plans and ensure the appropriate medical care is coordinated for the disabled, ill or injured. MicroHealth Case Manager helps keep track of cases, tasks, documents, notes, appointments, calls, email, health history and much more. Built on open source, it is highly customizable giving you the maximum freedom to personalize the software quickly and easily to meet emerging needs.
To ensure maximum effectiveness, case managers should look at the patient holistically to ensure the appropriate support systems are in place for long term sustainability. For example, though the patient’s health care may be managed, they may also suffer socioeconomic burdens contributing to their situation in totality. Therefore, the case manager should also help enroll the patient in programs like the United Way to help obtain subsidized housing and public medical programs which is far more cost effective than dialing 911. Annals of Emergency Medicine study found that programs providing frequent users a coordinated array of social and medical services had the potential to save millions in taxpayer dollars. However, it’s not only about socioeconomics. Annals of Emergency Medicine also found that only 15 percent of frequent users were uninsured, yet most were still primarily calling 911. This is as much a cultural issue with health uninformed patients that have complex psychosocial needs.
In an era of dwindling budgets and escalating need, it’s time to change the paradigm. An estimate by San Francisco General Hospital cited by the study showed that when the hospital provided case-managed, comprehensive care to those frequent users received 30 percent savings. Simply put, it is much cheaper to provide frequent users the broad array of assistance than leave them in constant need of ambulances and emergency rooms. Based on studies, we estimate cities can obtain a savings of approximately $6231.60 per frequent user per year after costs of implementing a case management intervention program.
Honestly, this is a no brainer! Unfortunately things won’t change very soon even though it’s obvious that a decent case management can save a lot of money. By focusing on delivering the best care possible to its frequent users instead of sending them home with a bag of pills will drastically lower emergency calls.
Oh, if only people in charge would hear you! I can’t understand why they wouldn’t want to save money while taking better care of people? Why? Because they are used to the old system and some of them can’t embrace change? Why do we all have to suffer because these people aren’t ready (and never will be) to change their ways?
Unfortunately humans are creatures of habit and many people are more comforted by routine rather than embracing change. All we can hope for is someone with an open mind to consider and implement some new ideas!
With all due respect, why aren’t those 20% paying more? I mean, I hardly ever need to go to a hospital and yet I still pay a lot of money each month while others that need it much more pay the same as me. I just don’t get it. Why aren’t we all contributing according to our own, personal needs? Maybe we could pay an amount up front, at the start of the year so hospitals would have enough money to function for 4-6 months and then we would individually pay each time we need to go to the hospital.