18.4.08

Maryland Gets Million+ to Reroute "Unnecesary ER Visits"

CMS just awarded my former homestate Maryland with a cool $1.78M.

Great coverage by Sue Schultz in the Washington Business Journal here. Sue also covers the healthcare funding beat for the Baltimore Business Journal.

The CMS capital injection will fund a task force composed of "3 regional healthcare teams" staffed with "several community care providers."

The team is, among other things, charged with "avoiding unnecessary emergency room visits."

MDs Department of Mental Health and Hygiene will get $732,216 this year for "creation of the teams" - that's $244,072 per team if all dollars are directed right to the bottom line, but there's no way they'll see that much in the budget line after DMHH gets an administrative/overhead cut.

This is a much nicer salary than 'community care providers' would earn as primary care docs - I'm wondering if they'll have a waiting list of PCPs lined up to submit applications.

And that's not even counting how much it will cost for them to hire a plethora of healthcare, public policy, and strategy consultants who will tell them how to form the teams.

In 2009, the budget for the teams goes up to $1.056M. If the teams have been formed by the end of this year (yeah &^%, ahem, yeah right), that means next year each team gets $335,200.

Figure a team of 6 - 4 providers and 2 consultants. That's a salary of $55,866.66 a year. Is this enough incentive to get a doc to tell a patient they shouldn't be in the ER?

And will DMHH provide legal coverage for the task force teams, since it's almost inevitable one of their providers will face some sort of litigation (helloooo EMTALA).


That's a good chunk of change for figuring out how to politely tell people who overuse the ER to go to he$%.......and if anyone from DMHH is reading, I propose you immediately retain Drs Scalpel, GruntDoc, and Whitecoat to advise you on how to do this with panache.

Unless they're planning on turning non-emergent patients away following triage, I'm not sure how much they'll get for the money.

This part of the article is what really worries me:

"In each of the region's, [sic] the state will try to redirect patients using the emergency rooms inappropriately to community care providers to reduce uncompensated care "costs at local hospitals."

So where will the task forces implement these new reforms?

According to Sue's article they will cooperate with "a regional hospital." It will be interesting to see which hospital was chosen. There are some big system players in the area, including Hopkins, University of Maryland, and Medstar.

Maryland isn't the only state to benefit from this windfall - CMS gave $50M out to 20 states.

If CMS ultimate goal is to indeed "slow spending growth" and "maintain access to coverage," I'm not sure 300 task forces would be enough to change the culture of ER overuse, let alone 3.