Use of a community care coordination team to reduce emergency department utilization and hospital readmissions for the highest utilizers

CONTEXT: A small percentage of patients comprise a high proportion of healthcare utilization, particularly the costs associated with Emergency Department (ED) visits and inpatient hospitalization readmissions. OBJECTIVES: The purpose of this study was to demonstrate a decrease in ED utilization and hospital readmissions in a selected group of super-utilizers post-intervention by a Community Care Coordination (CCC) team and to determine cost avoidance. METHODS: This was a retrospective chart analysis of selected super-utilizers enrolled in our CCC program. Each patient served as their own historical control to compare utilization rates, and a cost-benefit analysis was performed. RESULTS: A total of 368 patients participated in the CCC program during the specified time period. We found a significant reduction in ED visits and hospital admissions post-enrollment. The cost-benefit analysis showed an overall cost avoidance of $2,508,899.40, which is a 46 % cost reduction. CONCLUSIONS: Our study demonstrates a reduction in healthcare utilization and provides critical information to fix the significant, national burden that ED super-utilizers impose on the healthcare system. This program aligns well with the osteopathic principles of the whole-person approach, emphasizing prevention and wellness and prioritizing dignity in healthcare.