SOURCE: NCQA
“Up to 60% of all ED visits remain non-urgent and potentially unnecessary”
Each year, approximately 1 out of every 5 U.S. adults utilize the ED for health care. Common reasons for patients visiting the ED rather than urgent care or primary care facilities include:
- perceived severity of the medical problem,
- inconvenient doctor’s office hours and
- lack of access to primary care providers.
Up to 60% of all ED visits remain non-urgent and potentially unnecessary
Health plans can reduce ED utilization by ensuring appropriate disease management and care coordination are provided in primary care settings. Plans can also provide an alternative to the ED by increasing member access to primary care and urgent care settings.
ER visits costing +$1,000 each solve access issues. 24/7 virtual primary care at a capitated rate of less than $200 annual does too.
FROM A PHYSICIAN: My experience (many years ago in the ER) was that 90% didn’t need to be there. That premise was the genesis of what we now call UCC’s.
