Monday, September 17, 2012

Denying Insurance Reimbursement for Unnecessary ER Visits

Sounds like a good plan to me.  (Note to Republicans: We are not talking about "death panels" here.  Don't get excited.)

A med student we know mentioned recently the idea that one might charge $5 to speak to the triage nurse in the ER - $5 regardless of one's apparent station in life.  She mentioned that an ER somewhere tried it, and it sharpened things right up.

"The most obvious rule of social science is that people will abuse any free good," as we have previously referenced.

UPDATE:  As Carol notes in her comment, there's more to the link than what I cite.  (It's always good to read the whole thing.)  But I think that hitting someone in the pocket-book will get things moving more quickly.

1 comment:

Carol said...

Further from that article:
"It may not have occurred to Dr. Thompson and the other folks in charge of this “innovation,” but it seems self-evident that when a person repeatedly goes to an emergency room for problems that are not medically urgent, we are really talking about a social problem rather than a medical one. Heck, other states have recognized this reality. Oregon has launched a very useful and cost-effective program that essentially assigns a social worker to each high-cost Medicaid recipient. A major part of their job is to divert ER-abusing patients away from the emergency room and into keeping their regularly scheduled clinic appointments. As it turns out, sucking up an hour of social worker time is far less costly – and far more effective in changing behavior – than sucking up an hour of hospital and ER time. It makes sense once you bother to think about it. What the new Washington Medicaid program does is simply convert a social problem to an economic one, and then dump it on doctors and hospitals in the private sector. If this is the best government thinkers can do, we are all in some serious trouble. Heads should roll as a result of pulling this sort of stunt. Where’s the Queen of Hearts when you really need her?"