The Louisiana Medicaid program has created an emergency department (ED) utilization-reduction pilot that will run for the next 6 months, according to the Louisiana Department of Health. The program will identify ED “super-utilizers” in an effort to better align their access points with their health needs as appropriate. Acadian Health, a home-health provider, will deliver care to patients at home with urgent care mobile units, reimbursed by 6 local Medicaid managed care organizations—specifically encompassing 5 CPT billing codes. Services will be provided daily from 8AM to 10PM for patients ages 13 and older. Acadian’s Acute Care at Home for same-day care and Clinic at Home for scheduled visits are included in the pilot.
Solving for access: State data shows 20% of Louisiana Medicaid enrollees are high utilizers, seeking care in the ED an average of 17 times per year. The visits often include low-acuity presentations or ED access because of logistics such as the member’s lack of transportation to other providers. The goal of course is to reduce ED utilization which will reduce costs and increase capacity at local EDs for higher acuity concerns.