Reducing Emergency Room Utilization

Moving from Emergency Rooms to Medical Homes

The Metropolitan Washington region—which encompasses Northern Virginia, DC, Montgomery County, and Prince George’s County—is a region, like many others, where too many people rely on hospital emergency rooms to obtain their health services. Noting these trends, two of the region’s primary care associations have developed and implemented Emergency Department (ED)- Diversion Programs to reduce unnecessary use of emergency rooms and link people to appropriate medical homes.

The Primary Care Coalition (PCC) of Montgomery County, Maryland, and the District of Columbia Primary Care Association (DCPCA), have started projects to reduce reliance on emergency rooms for low income populations, who are often uninsured, especially in Maryland (1). The emergency room, as its name directly implies, is for emergencies—not for the treatment and management of chronic illnesses and especially not for any type of preventive care. Thus, not only are emergency room medical services expensive, but they do little to help improve health status and certainly don’t prevent health conditions from forming in the first place. The models PCC and DCPCA have used represent promising practices that might be helpful throughout the region and nationally. With the uncertainty of the economic environment, many new, previously employed people are finding themselves without health insurance for the first time and are turning to emergency rooms for their care, making these diversion programs increasingly important. These programs provide a vehicle for helping this new population become aware of the potential services available to them through the safety net system.

(1) DC has a high rate of insurance, even among low income populations. Department of Health Triple Aim presentation, September 1, 2009.

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