Push to reduce ED visits leads patients to urgent care, retail clinics — not telehealth

As payers increasingly turn to alternate modes of care delivery as a way to keep patients with low-acuity conditions out of expensive emergency departments, recent evidence suggests that urgent care centers and retail clinics — not telehealth — appear to be patients' go-to options, a JAMA Internal Medicine investigation has found.

A team of researchers led by Sabrina Poon, MD, a physician in the department of emergency medicine at Brigham and Women's Hospital in Boston, reviewed a set of deidentified claims data from Aetna between Jan. 1, 2008, and Dec. 31, 2015. The cohort included about 20 million insured members per study year.

Here are six study highlights:

1. Visits to the ED for low-acuity conditions decreased 36 percent during the eight-year study period.

2. Visits to non-ED facilities increased 140 percent.

3. Retail clinics saw the greatest increase in visits for low-acuity conditions (214 percent), followed by urgent care centers (119 percent).

4. Patients did not often utilize telemedicine for treatment. Specifically, telehealth saw an increase from 0 visits in 2008 to 6 visits per 1,000 members in 2015.

5. Utilization (31 percent) and spending (14 percent) per person per year for low-acuity conditions increased during the study period.

6. The increase in spending was driven by a 79 percent price hike per ED visit for the treatment of low-acuity conditions

"From 2008 to 2015, total acute care utilization for the treatment of low-acuity conditions and associated spending per member increased, and utilization of non-ED acute care venues increased rapidly," the study authors concluded. "These findings suggest that patients are more likely to visit urgent care centers than EDs for the treatment of low-acuity conditions."

To access the complete study, click here.

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