Avoidable emergency department (ED) visits add $32 billion to the nation’s health care costs annually, according to a new report from insurer United Healthcare, and hospice and palliative care providers are well positioned to help reduce that toll.
Nearly 66% of hospital ED visits by privately insured patients in the United States are avoidable, meaning that the patients could receive safe and effective care in a lower-acuity setting, such as in their homes or in a primary care setting, according to the report. The average cost of an ED visit is $2,032, United Healthcare found.
Hospice and palliative care in the home has been shown to reduce ED utilization as well as hospitalizations.
“The receipt of palliative homecare nursing decreased the rate of low-acuity emergency department visits and was significantly associated with a larger decrease in the rate of high-acuity emergency department visits,” a 2016 study in the journal Palliative Medicine concluded. “Receiving home care nursing with palliative intent may decrease the need for dying cancer patients to visit the emergency department, for both high and low-acuity visits, compared to receiving general home care nursing.”
Lower rates of ED leads to reduced health care costs. Palliative care in general can reduce health care costs by more than $4,000 per patient, according to a July 2017 study in Health Affairs.
All told, palliative care could reduce societal health care costs by $103 billion within the next 20 years, the nonprofit economic research group Florida TaxWatch said earlier this year in a report, primarily through reductions in hospitalizations, 911 calls, and emergency department visits.
Health care organizations, government stakeholders and payers are increasingly shifting towards a focus on delivering care in the home, be it hospice care, palliative care, home health care or other services. Reduced costs as well as benefits to patients are key drivers of this trend, particularly for older adults who may have difficulty travelling to health care appointments.
“With the exception of things that require an operating room, for example, almost everything else can be done equally well at home,” Diane Meier, M.D., executive director of the Center to Advance Palliative Care told Hospice News. “Providing care in the home also gives clinicians a very real sense of what the patient’s living situation is actually like and of the risks they face, more so than an office visit would.”