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How MedStar Saved $25 Million by Avoiding Unnecessary Emergency Services

1 Nov 2019 5:54 PM | AIMHI Admin (Administrator)

DHealthcare Source Article | Comments Courtesy of Matt Zavadsky

Will Maddox from DHealthcare does an excellent job profiling MedStar’s MIH programs in his article.  Although MedStar was one of the first, EMS agencies across the country are now doing similar programs, with similar results.

This IS EMS’ new value proposition in the transforming value-based healthcare environment!

To learn more about MedStar’s programs, and the EMS Transformation, click the links below:

http://www.medstar911.org/mobile-healthcare-programs

http://www.naemt.org/initiatives/ems-transformation

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How MedStar Saved $25 Million by Avoiding Unnecessary Emergency Services

10/31/2019by Will Maddox

These days, every aspect of the medical industry is looking to find cost savings, and 9-1-1 service is part of that movement as well. MedStar Mobile Healthcare, a North Texas organization that provides emergency services, has avoided over $25 million in medical costs for residents and payers over the past seven years.

 

The emergency department is one of the most expensive pieces of the medical industry, especially when it is full of problems that don’t belong in an emergency room. And when emergency physicians are operating out-of-network at in-network hospitals, surprise bills are end up with those who thought they were making the responsible decision in a time of emergency. These bills have made headlines and inspired legislation to fight them in past years. Emergency service providers can play an outsized role in avoiding these costs by treating problems upstream and diverting patients from expensive and often unnecessary services.

 

Created in 1986 to serve the Fort Worth area, MedStar is a public authority that provides emergency services, and the organization is governed by an appointed board from the fifteen cities the organization serves in North Texas. But despite the public governance, MedStar is not funded by tax dollars, and receives all of its funding through healthcare payers, just like other medical providers.

 

Because they are only paid when their services are necessary and only at set rates, they are forced to look for efficiencies where they can, and avoid services that won’t be reimbursed. The entity sees itself as a key player in avoiding unnecessary medical costs, which often occur in the emergency room. “We believe that we should have always been part of the solution,” says MedStar Executive Director Doug Hooten.

 

Patients known as high utilizers, who sometimes call 9-1-1 up to 20 times a month, are part of the problem, and MedStar has created initiatives to make sure that only emergencies receive ambulance rides to the emergency room.

 

For some people, navigating where to go with what problem can be daunting, and 9-1-1 offers a simple way to ensure that medical treatment will be received, but it isn’t efficient. MedStar created curriculum to train its staff to recognize whether an emergency transport or emergency room is necessary, and providers also look at medications to make sure several different doctors haven’t prescribed the same medication. The program also looks at social determinants of health to see if housing, food, transportation or other needs can improve conditions in a more appropriate and cost-effective way than calling an ambulance with every issue.

 

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