Keeping frequent flyers from landing in the emergency room was a key selling point of the Affordable Care Act, and proponents still hope that will happen, saving taxpayers money in the long run. But to date ER visits have soared because making sure folks without real emergencies make an appointment with a primary care doctor or go to an urgent care center has been a challenge.
Testament to that is emergency room visits are up at two of Albuquerque’s biggest health systems, despite the ACA’s promise that requiring everyone to have health insurance and expanding Medicaid would cut back those and other uncompensated costs.
It’s in part because new enrollees, out of habit, choose the emergency room even if it’s for a cold or a prescription refill, with taxpayers still footing that expensive bill. But Blue Cross Blue Shield New Mexico has a plan to ground some of those frequent flyers with more appropriate treatment by taking non-emergency care to some of its Medicaid patients.
The insurer has contracted with Albuquerque Ambulance and American Medical Response to provide paramedics who essentially make house calls. Services can include helping patients manage chronic conditions, following up after a patient is discharged from the hospital, reviewing medication and food levels in the home, checking vitals and educating patients about health.
The goal of the pilot Community Paramedicine program is to reduce 911 calls and ER visits and provide care and follow-up to Blue Cross Centennial Care members. The pilot program will be reviewed in a few months to see if those goals are being reached. And if they are, Blue Cross may offer the service to other health-care insurers.
This may prove to be smart thinking outside of the ER box for taxpayers and patients alike.
This editorial first appeared in the Albuquerque Journal. It was written by members of the editorial board and is unsigned as it represents the opinion of the newspaper rather than the writers.