We are all waiting to hear the Supreme Court’s decision on the health reform law (Affordable Care Act) this week. According to a recent Times article, “If it survives, about 93 percent of all non-elderly, legal U.S. residents will be covered by 2016. That’s up from 82 percent this year.” This translates to an additional 30 million people who will receive health insurance coverage.
Regardless of the outcome of the Affordable Care Act, there is a strong need to educate consumers on how to access and use the healthcare system. Research points out that recent changes in health insurance status for newly insured and newly uninsured adults are linked to greater emergency department use – not community health centers, family physicians or urgent care centers. An emergency department is truly one of the most inefficient options for people to use for non-emergent care. Providing health care in this forum ties up resources that can be better used, costs substantially more than care delivered in a lower acuity setting, and typically has much longer waiting times than other healthcare options.
Many Emergency Departments are now triaging patients as they enter the door. Some direct patients to other alternatives (at a lower co-pay) and some are using nurses to handle non-emergent problems. Signage and patient handouts can explain the reasons and the importance for doing this. Online videos are another option that many hospitals are using to explain where to properly seek care.
Once newly insured patients are aware of accessing other levels of care, an answer according to Robin Clarke, University of California, Los Angeles, may be the use of enabling services. These are non-medical services, typically delivered by primary care practices and community health centers, to help low-income patients access the healthcare system. These services address the social determinants of health care by helping patients figure out transportation to appointments, conducting case management assessments and performing community outreach and education activities.
Current research is being done to investigate how these patient-centered services will affect the delivery of health care to underserved patients. The results will affect not only the implementation, but also reimbursement. It will also impact how the patient-centered medical home concept will apply to the practices caring for these patients.
There are many other points of access to educate consumers. But, we need to make it a priority to do so.
This reminds me of the saying, “If we build it, they will come.” Unless we focus on education, they may come but never figure out how to use it.