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McKesson — Conference Presentation (June 2014)
11 slides from McKesson's conference presentation, Jun 24, 2014
Slide 1: Using Data to Address CMS Strategies for Reducing Nonurgent use of EDs
Connected Care & Analytics Using Data to Address CMS Strategies for Reducing Nonurgent use of EDs Carl Ray, RN-BC, FAEN Amy M Shehan, BS, MS Senior Business Advisor Business Advisor McKesson Enterprise Intelligence McKesson Enterprise Intelligence 16/24/2014 McKesson Corporation. All rights reserved
Slide 2: Overview
Connected Care & Analytics Overview • January 2014, Center for Medicare and Medicaid Services (CMS) published bulletin – Identifying three strategies for reducing Nonurgent Use of Emergency Departments. • Explore how to use data to meet these CMS strategies and help you answer questions like: – How
Slide 3: CMCS Informational Bulletin January 16, 2014
Connected Care & Analytics CMCS Informational Bulletin January 16, 2014 Reducing Nonurgent Use of Emergency Departments and Improving Appropriate Care in Appropriate Settings http://www.medicaid.gov/Federal-Policy-Guidance/downloads/CIB-01-16-14.pdf 3 6/24/2014 McKesson Corporation. All rights reser
Slide 4: Background
Connected Care & Analytics Background • Studies of Medicaid beneficiaries and their use of the Emergency Department estimate that non-urgent visits comprise only about 10 percent of all ED visits • Also suggest that higher utilization may be in part due to unmet health needs and lack of access to ap
Slide 5: CMS Strategies to Reduce ED Use: Broaden Access to Primary Care
Connected Care & Analytics CMS Strategies to Reduce ED Use Strategy 1: Broaden Access to Primary Care Services • When there is limited capacity in the appropriate setting, there is nowhere to redirect the patient to avoid unnecessary ED use Medical and Health Homes – typically have extended hours (
Slide 6: CMS Strategies to Reduce ED Use: Focus on Frequent ED Users
Connected Care & Analytics CMS Strategies to Reduce ED Use Strategy 2: Focus on Frequent ED Users • “Super-utilizers” (individuals with 4 or more visits per year) comprise 4.5% to 8% of all ED patients across payors but account for 21% to 28% of all visits • Frequent ED users are more likely to have
Slide 7: Strategy 2: Focus on Frequent ED Users (continued)
Connected Care & Analytics CMS Strategies to Reduce ED Use Strategy 2: Focus on Frequent ED Users (continued) • Examples of state and local efforts to address “Super- utilizers” Ambulatory Clinic on Site at ED – Clinics created to provide enhanced outpatient care to high utilizers of acute care ED
Slide 8: Strategy 3: Target needs of people with behavioral health problems
Connected Care & Analytics CMS Strategies to Reduce ED Use Strategy 3: Target needs of people with behavioral health problems • About 12.5% of all ED visits across payors are due to mental health and/or substance abuse treatment needs Medical Homes for People with Substance Abuse Problems – Program
Slide 9: Differentiating Emergency and Non-Emergency Use of the ED
Connected Care & Analytics Differentiating Emergency and Non-Emergency Use of the ED • EMTALA obligations must be fulfilled • Different methods have been used to distinguish emergent from non-emergent care before a full evaluation is done; however no two methods appear to agree • A recent study (JAM
Slide 10: Analytic Demonstration
Connected Care & Analytics Analytic Demonstration 10 6/24/2014 McKesson Corporation. All rights reserved. Confidential and Proprietary.
Slide 11: For more information contact
Connected Care & Analytics For more information contact: James Polachy – james.polachy@mckesson.com Shannon Revelia – shannon.revelia@mckesson.com Amy Shehan – amy.shehan@mckesson.com Carl Ray – carl.ray@mckesson.com 11 6/24/2014 McKesson Corporation. All rights reserved. Confidential and Proprietar