The efforts are aimed squarely at one of the biggest conundrums emerging from the passage and implementation of the Affordable Care Act. Still, the immediate savings of more than $1 million make the effort appear worthwhile if the patients continue to see their new doctors and don't return to their ER habits. "We're doing this strictly out of our own budget," Huber said. It's a limited group and won't solve all the problems of inappropriate emergency room use. Compared to four months before the program, the cost fell from $1.5 million to $440,000. In the first four months, visits by these 39 people to the Aurora Sinai emergency room fell by 68 percent, from 487 to 155. They even sometimes accompanied them to the visit.Īfter the visit, the social workers ensured that the patient made at least two follow-up appointments. Then they helped the patient make a first appointment. The social workers developed a plan for each patient that included finding transportation to a doctor and securing child care for the appointment. They can't think about making appointments and planning ahead." "They don't know where they're going to sleep or whether they can get groceries. "These are people who are in crisis all the time," Huber says. The social workers chose 39 people out of the 313 and spent the next eight months trying to change their habits so that when they get sick, they go to a primary care doctor or clinic rather than the ER. Those patients alone accounted for 1,827 emergency room visits in that time. It then identified 313 so-called frequent fliers who visited Aurora Sinai's ER at least five times in four months. Huber says the hospital placed social workers in the ER full time. "We're targeting the high utilizers of the emergency department," says Mark Huber, the hospital's senior vice president of social responsibility. But it's showing promise in getting patients connected with primary care doctors and in cutting ER costs. The pilot project at Aurora Sinai Medical Center, the only hospital left in a mostly poor, black area of downtown Milwaukee, is labor intensive. Below are the health plans and their contact information.Aurora Sinai Medical Center in Milwaukee has found that connecting people with primary care doctors reduces the number of emergency room visits.Ī Milwaukee hospital is trying a new approach to get newly insured residents to stop using emergency rooms as their main source of medical care and develop relationships with doctors instead. To change your primary care provider (PCP) within your current health plan’s provider network, please contact your health plan. You are a federally recognized tribal member or qualify for services through Indian Health Service (IHS).You need services to address a mental health disorder, substance use disorder, intellectual/developmental disability (I/DD) or traumatic brain injury (TBI).You can change your health plan at any time for these reasons: Some people can change their health plan at any time. To learn more, call at 83 (TTY: 711 or ) or use the NC Medicaid chat tool to chat online. NC Medicaid will send you a letter telling you when you can choose a new health plan without a special reason. Mail or fax the Health Plan Change Request form.Call us toll-free at 83 (TTY: 711 or ). You will need to have your NCID ready to log in and request to change your health plan. Online with your NC Medicaid Managed Care account and submit the form.If you want to change your health plan outside of the 90 days, you can request to change your health plan in one of the following ways: Other reasons (poor quality of care, lack of access to covered services, lack of access to providers experienced in dealing with your health care needs).Your health plan does not cover a service you need for moral or religious reasons.Your Long-Term Services and Supports (LTSS) provider is not in your health plan.A different health plan may be better for your complex medical conditions.You cannot get all the related services you need from providers in your health plan, and there is a risk to getting the services separately.You have a family member in a different health plan.You moved out of your health plan’s service area.If you have a special or “with cause” reason, such as:.If you are required to change health plans.After that, you can change your health plan: When you enroll in a health plan, you can change your health plan for any reason within 90 days. Most people can change their health plan within 90 days of health plan enrollment.
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