Community health centers seen as key to reducing emergency room cost

Community health centers are key to reducing excessive visits to the emergency room, the Government Accountability Office said in a report released Wednesday ahead of a Senate HELP Committee hearing on the issue.

The report analyzed three strategies health centers use to reduce non-urgent visits to hospital emergency rooms. These include emergency department diversion, such as educating patients about the correct use of emergency rooms and the services provided by health centers; care coordination that focuses on prevention; and making health center services more accessible, by offering evening and weekend hours and providing same-day or walk-in appointments for example. 

"Health center officials told us that they have limited data about the effectiveness of these strategies," the GAO says, "but some officials provided anecdotal reports that the strategies have reduced emergency department use."

The overuse of emergency rooms contributes greatly to the nation's high healthcare costs. The problem is expected to worsen in the short-term under Democrats' healthcare reform law because the Congressional Budget Office estimates that gaining insurance increases people's demand for healthcare services by about 40 percent.

Use of emergency room services per person increased by 11 percent in the decade ending in 2007, GAO said. Of the 117 million visits that year, about 8 percent were classified as nonurgent.

The report goes on to describe challenges the health centers face in putting their strategies in place. These include: a lack of reimbursement for case managers who coordinate care; the difficulty in getting patients to change their behavior with regard to emergency room use; and challenges to recruiting health providers to serve health center patients.