Wednesday, July 14, 2010

Right care, right time?

Mikaela says:
Okay, I have to post this letter from a local health care provider almost in its entirety or you won't believe it. Has it really come to this? Do that many people really drop everything and decide to spend umpteen hours waiting to be seen at the emergency room for ... hangnails or something else that can wait for an appointment? Really?

One way Presbyterian is working to help lower the cost of health care is to make sure patients get the health care they need in a setting that is most appropriate for the level of care they need. That’s why the Presbyterian Hospital Emergency Department is starting a new process for helping patients who come to the Presbyterian Hospital Emergency Department with non-emergencies beginning July 26, 2010.

All patients who enter the Emergency Department at Presbyterian Hospital will receive a medical screening exam to determine their appropriate level of care. Patients with conditions that are not emergencies will be directed to an onsite patient navigator, who will make an appointment for patients to be seen quickly in a primary care office or refer patients to urgent care if primary care is not timely enough or inconvenient.

If patients still wish to be treated in the emergency department after being informed their condition is not an emergency, they will be required to pay for services at the time of treatment. Under these circumstances, the health plan will likely not reimburse the patient.

Through this effort, emergency department services will be better accessible for patients with life-threatening emergencies. All State and Federal laws and regulations will continue to be followed to ensure patient safety and protect the health care system. Careful monitoring will occur to ensure patients receive timely care and patient safety is not compromised.

Patient education is central to helping patients determine the “right level of care at the right place” for their medical condition. We hope you will join us in our efforts to help educate your employees about accessing care most appropriately and maximizing their insurance coverage for the level of care that their health requires. Of course, true emergencies will continue to be covered by insurance, according to your Group Subscriber Agreement or Summary Plan Description.

We are very optimistic about this new and innovative approach as we work to make healthcare more affordable, accessible, and of the highest quality.