BIDDEFORD, Maine (NEWS CENTER) -- Health care costs have been skyrocketing in recent years, and overuse of emergency rooms is a big reason why.
A study published by the Muskie School of Public Service in 2010 found that Maine's emergency room use in 2006 was 30 percent higher than the national average. Now, health care providers have been taking steps to reduce those numbers, mostly through increased use of primary care.
In 2009, Southern Maine Medical Center began an effort to increase primary care use because it was experiencing an alarming increase in emergency room visits -- 18 percent between 2002 and 2008. The number of patients coming to the emergency department who didn't have a Primary Care Physician was going up 2 percent a year.
Dr. Mike Albaum, SMMC's Chief Medical Officer said the visits were causing a lot of unnecessary expense. He said, "This place is set up for true emergencies, and people are showing up with sore throats, bumps, strains and sprains that didn't really require an emergency department level of care."
So starting in 2009, SMMC widened its network of primary care physicians, and when patients without a primary care physician showed up at the emergency room, they were given a list of available doctors in their area. The hospital's free care program covered preventive care visits for those without insurance who were unable to pay. Emergency room visits actually decreased in the first year of the program, and have remained stable ever since. And the number of patients coming to the emergency room who didn't have a primary care doctor went down 41 percent between May of 2009 and February of 2010.
Dr. Albaum said, "It's difficult to track through patient by patient that it's because of that system. But anecdotally, you'd see people that would then come to the office and were grateful that they didn't have to go to the emergency room for routine items."
Intermed, a primary care provider, along with the health insurer Aetna, also have had success in reducing hospital visits among patients with chronic conditions. In 2008, they created an Accountable Care Organization. Patients with diabetes, certain kinds of coronary disease, and asthma had more frequent visits with a doctor-led team that came up with a plan to manage the disease. Intermed expected this kind of care model would eventually lead to lower costs and fewer emergency room visits, but the results of the pilot were better than they expected. Patients in the program spent fewer days in the hospital compared with Medicare patients statewide, and had 56 percent fewer re-admissions. Plus, the program saved an average of $620 a year per patient, as compared to non-Intermed patients.
Dr. Thomas Claffey, the Intermed physician who co-authored the report on the study said, "What this pilot project showed was that the investment in more intensive panel management and more intensive outreach to patients resulted in decrease in health care costs now."