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New Hampshire Studies Frequent Emergency Department Users In Medicaid Program

Ruzanna Harutyunyan's picture

The New Hampshire Department of Health and Human Services (DHHS) Office of Medicaid and Business Policy (OMBP) announce results from a study of frequent emergency department (ED) use by New Hampshire Medicaid members. The report is part of OMBP's Comprehensive Healthcare Information System (CHIS) project.

It was developed to provide data on the prevalence, utilization, and payments associated with frequent ED use (four or more visits per year) among the NH Medicaid population in 2006.

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"It is important to gain greater insight into elevated use of the Emergency Department," said DHHS Commissioner Nicholas Toumpas. "This will help to not only improve efforts in directing patients to the most appropriate use of care, but ultimately will also help to control costs."

The study revealed Medicaid recipients classified as frequent ED users often used the ED for conditions that were previously identified as possibly non-urgent or treatable in a primary care setting. While frequent ED users represented only 5% of the Medicaid population, they incurred 41% of the total Medicaid outpatient ED visits during 2006, resulting in $7.8 million in payments.

Numerous studies have linked higher rates of ED use to inadequate access to primary care. However, Medicaid members who were frequent ED users had higher rates of accessing primary care compared to other Medicaid members and had the same rate of preventative visits.

"By conducting an in-depth study of frequent users of the Emergency Department," said Director of the Office of Medicaid and Business Policy Katie Dunn, "we are better able to focus initiatives directed at improving access and coordination of care. We are also able to provide a baseline for evaluating our program efforts."



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