Nonemergent Care Access Plans

The Problem

Avoidable ED utilization is one of the largest recoverable costs in most populations, and it concentrates in the most vulnerable patients: those without a medical home, reliable transport, or same-day access to primary care. Sending them a letter does not change behavior. Neither does a care management program that never reaches them.

What works is a team-based model embedded in the emergency department itself, paired with a real same-day access partner.

What We Do

• Create: build the nonemergent care access plan with population of focus, workflows, goals, success measures

• Implement: operationalize inside the emergency department. Elect physician and nurse champions, implement a medical screening exam process, build a real-time flag for avoidable visits, and embed a care team of social workers, community health workers, and nurses in the ED workflow.

• Results: process and outcome dashboards, ROI calculation, expansion planning

• Partnerships: form same-day access relationships with FQHCs, aligned through contracting and shared goals
  The work also addresses social determinants directly: transportation, food, pharmacy costs, phone access, housing, and durable medical equipment. 

What You Get

• A submitted, compliant nonemergent care access plan

• An operational ED-embedded care team with defined workflows

• Executed FQHC or primary care partnership agreements

• Utilization dashboards and ROI reporting

• The VHI Nonemergent Care Access Plan Checklist

Results

32% decrease in ER utilization, and millions saved in uncompensated care while improving outcomes for the most vulnerable patients in the population.