USE CASE: Emergency Department Utilization Project

Colorado Children’s Healthcare Access Program (CCHAP) is a nonprofit organization whose mission is to promote and support medical homes to improve health outcomes for children and advance health equity.

Project Summary: CCHAP is using CO APCD data to evaluate a plan to reduce the number of children on Medicaid that go to the emergency department or urgent care for treatment better provided in a medical home setting. Using a number of practice interventions, the parents are encouraged to phone the practice first so clinical triage professionals can help families decide whether or not they should use urgent or emergency services versus managing care at home or scheduling a convenient appointment with the clinic. Preliminary results suggest ED visits have been cut in half at significant savings to both commercial and public insurers.

Benefit to Colorado: With this project, CCHAP’s goal is to improve current clinical practice and outcomes by encouraging use of the medical home as the preferred alternative for acute primary care issues. This shift in treatment settings could lower costs and improve care for young and vulnerable Coloradans.