In 2017, Jackson Memorial Hospital realized they were spending millions of dollars on their emergency department and that a large amount of that money was geared toward the Miami Health System’s most frequent emergency department patients. Particularly troubling: these ED visits often weren’t emergencies and may have even been preventable.
After realizing they could save taxpayer money by getting these patients into the lowest appropriate cost of care setting, the hospital hired Plante Moran to develop a program to better manage the medical conditions, behavioral health, and social determinants that were circulating people through their emergency department. First, we built a custom algorithm designed to identify these frequent visitors. This computer code helped identify Jackson Health System’s patients who were uninsured or underinsured, had no primary care physician on record, and who had visited the emergency department five or more times in the prior year.
Once the algorithm determined the patients, we provided the hospital with case management protocols; today, a variety of case managers help arrange transportation for doctor’s visits, accompany patients to the physician’s office, and assess their progress. After “graduating” the first 100 of these patients, Jackson Memorial Hospital estimates it has already saved about $3 million dollars.