When an Emergency Isn't' an Emergency

A regional Accountable Care Organization(ACO) faced mounting pressure on its emergency department resources due to a significant spike in utilization. A detailed analysis revealed that many of these visits could have been managed in alternative care settings, highlighting a critical opportunity to optimize resource allocation and enhance patient care. Redirecting appropriate cases to the right treatment venues became a priority for both cost efficiency and improving patient outcomes.

Data-driven Intervention

Partnering with Koan Health, the ACO leveraged the power of Datalyst’s population health analytics platform to address the issue strategically. This included:

• Implementing a Targeted Intervention Strategy: Datalyst's analytics identified high-utilization trends and flagged avoidable ER cases.

• ‍Launching a Patient Education Campaign: The campaign provided clear guidelines on when to choose the ER versus urgent care, enhancing patient decision-making.

• ‍Deploying Care Coordinators: Coordinators were pivotal in identifying avoidable ER cases and redirecting patients to appropriate care settings.

• Developing Comprehensive Marketing Materials: These materials empowered patients with accessible information, improving their understanding of healthcare options.

"Koan Health’s data-driven approach enabled us to optimize our ER resource allocation while significantly improving how we deliver and coordinate patient care. Their partnership has been instrumental in driving measurable, meaningful change for our organization and the patients we serve.”

– ACO Executive, Regional ACO

Measurable Impact

Through Koan Health's data-driven approach, the ACO achieved measurable success:

• 20% Reduction in ER Visits: Avoidable visits dropped significantly, easing the strain on emergency departments.

• 44 Visits Decreased per 1,000 Patients: Utilization metrics confirmed the program’s effectiveness.

• Improved Resource Allocation: ER resources were optimized to focus on critical cases.

• Enhanced Patient Education and Access: Patients were better informed and directed to the most appropriate care settings, fostering trust and satisfaction.

The success of this emergency department optimization initiative demonstrates the powerful impact of combining data analytics with strategic intervention. The partnership with Koan Health and the implementation of Datalyst has solved immediate ER utilization challenges and positioned the ACO for continued success in managing population health. As healthcare continues to evolve, this foundation of data-driven decision-making and strategic resource allocation will be crucial for maintaining high-quality, cost-effective care delivery.

"The success of this emergency department optimization initiative demonstrates the powerful impact of combining data analytics with strategic intervention. Their partnership with Koan Health and Datalyst has solved immediate ER utilization challenges and positioned this ACO for continued success in managing population health. This foundation of data-driven decision-making and strategic resource allocation is crucial for maintaining high-quality, cost-effective care delivery." - DT Nguyen, Founder and CEO, Koan Health

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About the Client

• Regional ACO managing 200,000 lives across commercial, Medicare Advantage, and MSSP programs
• Non-profit health system serving more than one million patients annually
• Nationally ranked and recognized for excellence in safety, quality and patient experience