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In an attempt to improve patient outcomes and reduce care costs, ACOs in value-based care models across the country have devoted significant attention to the inpatient setting—focusing care management resources on inpatient discharges in particular. This is understandable, given the risk associated with that transition of care and potential for 30-day readmissions, which impact ACOs from a total medical expense (TME) perspective as well as quality measures performance.
However, ACOs that focus almost exclusively on inpatients risk neglect a much earlier opportunity to support their members’ care—as they enter the Emergency Department (ED).
The ED is the healthcare gateway for many vulnerable populations, providing a first look into a patient’s background and care histories. The ED is also an inflection point that offers cost savings opportunities. ACOs should ensure they have robust strategies and solutions in place to engage members in the ED and optimize care decisions out of the gate.