published Friday, July 18th, 2014

BlueCross awards Erlanger $1 million to cut ER 'frequent fliers'

Erlanger Medical Center
Erlanger Medical Center
Photo by Tim Barber.

BlueCross has awarded Erlanger a $1 million award to help fund a new team to bring down the number of emergency room “frequent fliers” — high-risk, elderly patients with no primary care doctor who use the ER to get treatment.

BlueCross BlueShield of Tennessee has awarded the Erlanger Health System $1 million for “innovation initiatives” meant to bring down the number of high-risk patients who make repeat visits to the emergency room.

The award will help Erlanger develop its “Care Transition Team,” which targets “high-risk” patients — those with conditions such as congestive heart failure and COPD — who are 65 and older, have no primary care physician and make repeated visits to Erlanger’s ER within a six-month period.

Within one week of one of these patient’s visits to the ER, a designated navigator on the Care Transition Team will make a phone call to the patient to make sure the patient is taking medications, to encourage a primary care visit, and to see if more assistance is needed.

Erlanger CEO Kevin Spiegel said in a joint statement that the funds will go toward “more coordinated, patient-centered” care, and offer targeted treatment and aftercare services for the chronically ill or injured individuals.

BlueCross leaders said the “Innovation Award” payment is part of a five-year strategic partnership between Erlanger and BlueCross announced last April.

The partnership made Erlanger the only Chattanooga health system in the BlueCross’ new narrow network called Network E.

There are now more than 10,000 subscribers in the Erlanger-only Blue Network E, which has allowed Erlanger to increase its commercial business, Spiegel said.

“Our mutual goal in this collaborative effort was to develop innovative approaches — like Erlanger’s Care Transition Team — to deliver high-quality, cost-effective health care,” BlueCross CEO Bill Gracey said in the statement.

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