Medicaid recipients who go to Tennessee emergency rooms with nonemergent complaints cost the state nearly $85 million a year, according to a report published online by WATE television in Knoxville. The data show federally and state-funded nonemergent ED visits drove up costs 25% in 2016 compared with the previous year. Some of the most common complaints that could have been treated in a lower-acuity (and less costly) setting like urgent care included acute upper respiratory infection (24,257 claims at a cost of $2.9 million); acute pharyngitis, unspecified (15,880 claims, $1.7 million); acute bronchitis, unspecified (14,680 claims, $2.6 million); and streptococcal pharyngitis (10,115 claims, $2.4 million). Regardless of how many Medicaid patients visit your urgent care center, the data further prove the industry’s contention that too many patients are in the ED with potential illness that doesn’t meet the standard for an “emergency.” Continuing to build relations with primary care practices (who may be referring patients to the ED after hours or if they can’t make room on their schedule) and health systems that could refer to your locations instead of the local hospital can only serve the interests of both parties—and the patient.
Report: Nonemergent ED Visits Cost Tennessee Nearly $85 million a Year