The Health Care Authority is working with the Washington State Hospital Association and physicians on a legislative mandate to reduce non-emergency use of hospital emergency departments, as well as over-utilization of emergency services.
The plan – included in the Supplemental Budget passed April 11 by the legislature – replaces earlier state proposals that would have limited the annual number of non-emergency visits by a client to an emergency department and to stop reimbursing hospitals and physicians for treatments and services that are not medically necessary in the setting of an emergency department. Key features of the plan, which will be implemented beginning July 1, will require hospitals to formally commit to:
Distribute information to clients on the appropriate use of emergency department services.
Work together to establish systems for referrals of non-emergencies to primary care providers within a 72-hour window.
Establish protocol for feedback reports so the state and individual hospitals can track emergency department use and services received.
Implement guidelines developed by emergency department doctors around the state to identify narcotic-seeking behaviors and to share decision-making information about narcotics prescribing.
Continued collaboration between state, doctors and hospitals to troubleshoot issues and concerns that surface after July 1.
The legislative budget proviso endorsing the new Emergency Department policy calls for $31 million in savings (includes both state and federal matching funds) as a result of the changes.