October 2018

Reducing Avoidable Emergency Department Visits

Emergency Department (ED) utilization for preventable emergency room visits is costly and diminishes the quality of care given to patients. The rising costs strain resources for patients, providers and payers. Patients seeking avoidable emergency services also hinder themselves from adequate care coordination that the primary care structure provides.

One research study found that an average of 37 percent of all ED visits in the U.S. were non-urgent. And, in 2016, the leading condition for ED visits in Texas was upper respiratory infections. Upper respiratory infections are potentially preventable events that can be treated by a primary care physician in the office rather than the ED. Focusing on preventive care will help reduce ED overuse and ensure health care sustainability.

How to Help Reduce Avoidable ED Visits

• Talk to your patients about proper ED use. Urge them to call you, their provider, when they are contemplating an ED visit.
• Schedule preventive checkups (well-child or Texas Health Steps) for your patients. This can help ensure they are obtaining and taking prescribed medications as directed.
• As an alternative to calling you, your patients can call Blue Cross and Blue Shield of Texas’ (BCBSTX) 24/7 Nurse Hotline at 1-844-971-8906 *TTY 7-1-1. They can speak with someone in English or Spanish, and interpreter services are also available.

This helpline is staffed 24 hours a day with registered nurses who can help patients get answers to their health questions. If an unexpected medical situation arises, a nurse can help patients decide if they should call their doctor, visit the ED or urgent care, or treat the problem themselves.

If you have any questions for BCBSTX’s Quality Improvement Department, please reach out to: