Indiana Medicaid Wasted $150 Million On Unnecessary Emergency Room Visits

Research has shown the state of Indiana medicaid system spent $500 Million on emergency care services.Researchers found 30% of that ($150 Million) was avoidable.

Here’s more from OurHealth.org:

OurHealth, a leading provider of employer-based clinic solutions, leveraged its data analysis expertise to uncover more than $150 million in potential Medicaid savings in the form of avoidable emergency department visits as part of the Indiana Chapter of the Healthcare Information and Management Systems Society’s first-ever Indiana Medicaid Data Challenge. The analysis earned OurHealth’s team First Place in the one-day hackathon.

As part of its winning entry, the OurHealth data team utilized Emergency Department data sets containing over $500 million worth of emergency spend over the previous 5 years. Seeking the answer to the question of how much of this spend was potentially avoidable, the team utilized the NYU probabilistic decision tree algorithm, the AHRQ Clinical Classification System, and more than two dozen data sets.

The team’s analysis – presented in an interactive infographic via Tableau – revealed that more than $150 million over the 5 years’ worth of potential ED visits which would have been better served by primary care and another potential $100 million or more of those by non-emergent acute care.

 

 

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