More than one-third of emergency department (ED) use is for non-emergent primary care conditions that would be more appropriately cared for in a community-based primary care setting. To address this issue, NJHA’s Health Research and Educational Trust of New Jersey partnered with the New Jersey Department of Human Services, Division of Medical Assistance and Health Services and the New Jersey Primary Care Association to develop and implement a demonstration model providing:
- Alternate non-emergency services to patients who present with primary care needs in hospital emergency departments
- Patient education
- Support services to encourage the use of appropriate sites of care
This model was pilot tested in two sites with support from the Centers for Medicare and Medicaid Services through subsection 1903(y) of the Federal Deficit Reduction Act of 2005. Each pilot site implemented a partnership of a hospital with a federally qualified health center. Pilot sites were selected based their location in a county with a high rate of ED use by Medicaid beneficiaries and certain demographic characteristics. The project primarily targeted Medicaid patients, but the ultimate goal was to provide care to all New Jersey residents at the most appropriate, efficient and cost-effective site.
Major components of the project model include:
- ED express care
- Referral for primary care follow up
- Patient education
- Care coordination and management
- Case management
- Communication/linkages between partners
Despite some variations across pilot sites, this project resulted in very positive changes toward the goals of promoting the use of medical homes and appropriate sites of care, reducing utilization of hospital EDs for non-emergent, non-acute primary care services and containing the cost of ED expenses for providing primary care services.
