Here is a little add-on to the previous blog about the Deferral of ED Care Boondoggle, using data from a white paper from the Pricewaterhouse Coopers’ Health Research Institute on ‘The Price of Excess‘ in health care spending. This paper address the sources of ‘waste’ in our health care system, and puts in perspective the assumption that so-called ‘unnecessary ER visits’ is a major contributor to this problem. The pie chart below comes courtesy of Dr. Susan Schneider and Dean Wilkerson at ACEP, using data from the PWC white paper.
Unfortunately, PWC used as reference for the ‘unnecessary ER visit’ costs the difference between the average cost of an ER visit and the average cost of an office visit, provided by Wellpoint BCBS. If, instead of using the average cost of all ER visits, PWC had used the average cost of non-urgent ER visits (patient did not need to be seen within 2 hours of presentation), the tiny slice of the pie sticking out would have looked more like a tiny sliver. The point of this visual representation is that if states like Washington are looking for places to save money in their Medicaid program, they ought to be focusing on the rest of the pie, where significant opportunities for savings exist, instead of putting patients and the safety net at risk trying to squeeze these savings out of ER care. It’s like trying to make a bottle of wine by crushing a single grape.