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Firefighters may make limited emergency room trips – Pamplin Media Group

City Council to consider ordinance breaking with traditional arrangement with private ambulance companies on Wednesday

In a small but potentially important move, Portland Fire & Rescue is asking the City Council for permission to bill Medicaid if it transports people to hospital emergency rooms.

Although PF&R crews respond to 63,000 medical calls each year, patients have historically been transported to emergency rooms by private ambulance companies. The arrangement has been questioned by some because PF&R crews and private ambulances respond to almost every medical call at about the same time.

City officials have discussed authorizing PF&R to do the transporting for several years. Interest has grown since the passage of the Affordable Care Act, which authortized Medicaid to pay for such trips when the patients do not have private insurance.

An ordinance to be be discussed by the council on Wednesday would authorized PF&R to transport patients to emergency rooms “in unique and unusual circumstances.” They are described as “high transport demand resulting from a major incident, excessive ambulance response delays caused by extreme weather, or a delayed ambulance response for a critical patient.”

According to the ordinance, transport fees in Multnomah County are set by the Multnomah County Contract Compliance and Rate Regulation Committee. Current charges are $1,008 plus $23.17 per mile. An impact statement accompanying the ordinance estimates PF&R could collect approximately $10,000 a year in additional revenue if the ordinance passes.

No additional PF&R employees would need to be hired, the impact statement says.

You can read the proposed ordinance and impact statement at http://www.portlandoregon.gov/auditor/article/651754.

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TennCare non-emergency ER visits cost $84 million – WATE 6 On Your Side

JOHNSON CITY, TN (WJHL) TennCare recipients cost taxpayers nearly $85 million by going to the emergency room for common colds, headaches, toothaches and other non-emergencies, according to the most recent available state data.

The data show federally and state-funded non-emergent ER visits resulted in a 25% increase in cost in the 2016 fiscal year compared to the prior year.

State records identified at least 126,000 visits in one year alone, including 24,257 visits for acute upper respiratory infections, 14,178 visits for headaches, 11,420 visits for strep throat, 10,115 visits for nausea with vomiting, 9,918 visits for lower back pain, 9,098 visits for viral infections, 8,323 visits for fevers and 8,161 visits for toothaches.

(Division of TennCare)

This is a long-term problem, TennCare Chief Medical Officer Dr. Victor Wu said.

Dr. Wu said the states Medicaid program is trying to come up with a solution by working to convince its 1.5 million patients, which include low-income pregnant women, children, the elderly and people with disabilities, to get regular checkups with a primary care physician and not just go to the doctor when they are sick.

Everyone needs to have a relationship with their primary care provider, Dr. Wu said. I think if we can begin to turn the tide more toward prevention and turn the tide more toward focusing on wellness I think that will help, in general, offload some of the challenges we see when people do get sick and where they need to go.

In addition to that effort, Dr. Wu said TennCare is increasing patient interventions, including face-to-face meetings, phone calls, text messages and letters and working with hospitals to help direct patients through the proper path of care.

I think were still trying to work through all different avenues and all different channels, he said. It is really challenging.

TennCare also reports it implemented a new policy several years ago that caps the amount of money it reimburses hospitals at $50 per non-emergent ER visit, which incentivizes hospitals to better educate the public. However, the states own numbers show more education is needed, particularly in East Tennessee, which is responsible for more than $30 million of the total $84 million expense.

Its an opportunity, Dr. Shari Rajoo said. It also is a signal that there is definitely a misunderstanding of the purpose of the emergency room. I think we really have to reorient ourselves to the emergency room is for life or limb threatening situations and Is this one of those situations? Can I wait until the morning?

Mountain States Health Alliances AnewCare Collaborative has spent the last several years trying to drive the message home that primary care is not only more affordable, but ultimately better for a person and societys overall health. At the ER, doctors arent specialists in treating chronic health problems. Instead, theyre focused strictly on emergency care and often times, only have a snapshot of a patients medical history. AnewCare Collaborative President Paige Younkin said MSHA is also trying to give patients support so they can call their care coordinator for advice about how best to treat their health issue and avoid the ER altogether.

The patients better off because their care if coordinated, Younkin said. There is, for lack of a better word, theres a captain of their ship.

The AnewCare Collaborative, led by both women, is targeting certain patient demographics, using disease-specific initiatives to spread the message and trying to make primary care and urgent care more convenient.

Were working on establishing easier scheduling, open scheduling, maybe looking at different hours, so that theyre more flexible, so the patient is able to go there instead of the emergency department, Younkin said.

Even with all of these efforts, the chairman of the Tennessee Senate committee in charge of TennCare oversight said there is only so much the state can do.

It really is troubling, Sen. Rusty Crowe (R), District 3, said.

Like his counterpart in Congress Rep. Phil Roe (R), District 1, Sen. Crowe said states need flexibility too that will only come from federal healthcare reform.

The federal laws restrict our hospitals with regard to what we can do with Medicaid patients, Sen. Crowe said. Untie our hands and let us do what we need to do at the state level.

I strongly agree that states need more flexibility in how they structure their Medicaid programs so first-class people arent receiving second-class care, Congressman Roe said in a statement. This is why we prioritized Medicaid reform as part of the American Health Care Act that will help move towards a health care system that lowers the cost of care and empowers patients so they arent relying on emergency rooms for primary care.

Experts say non-emergent visits arent just costing taxpayers money and costing TennCare patients better care, theyre also tying up the ERs critical service, which delays care for people who really need emergency help.

It just increases the wait time, Dr. Wu said. We want to help shift them to more prevention and wellness as opposed to just acute sickness.

MSHA said patients should contact their primary care office for most medical problems, including urinary symptoms, cough/congestion, flu, earaches, sore throats, migraines, fever, constipation, rashes, minor cuts and burns, regular physicals, prescription refills, vaccinations, screenings and advice.

Meanwhile, the health system said patients should use urgent care when it is not an emergency, but waiting to see your primary care provider is not an option. Urgent care facilities can order any necessary bloodwork and can assist with urinary symptoms, cough/congestion, flu, earaches, sore throats, migraines, fever, constipation, rashes, sprains, back pain, minor cuts and burns, minor broken bones or minor eye injuries, MSHA said.

MSHA said patients should go to the ER for chest pain, severe abdominal pain, coughing up or vomiting blood, severe burns, deep cuts or bleeding that wont stop, sudden blurred vision, sudden difficulty breathing or shortness of breath that is not relieved by inhalers, sudden dizziness, weakness, or loss of coordination or balance, sudden, new numbness in the face, arm, or leg, sudden slurred speech, sudden severe headache (not a migraine), seizures and any other condition you believe is life-threatening.

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TennCare non-emergency ER visits cost $84 million – WATE 6 On Your Side

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Teen ER Visits During Lolla Dropped, But It’s Still Worst Drinking Weekend – DNAinfo

Teenage emergency room visits tied to Lollapalooza have fallen in recent years, but the music festival is still the worst weekend of the year for teen drinking in Chicago, Lurie Children’s Hospital says. View Full Caption

DNAinfo/Justin Barbin

DOWNTOWNLocal hospitals have reporteda huge drop in teenage emergency room visits associated with Lollapalooza, but the multi-day music festival is still considered the worst weekend of the year for underage drinking in Chicago.

Just 65 festival attendeesbetween 13 and 18 years old were sent to an emergency room during last year’s Lollapalooza, down from 121 teenage hospital visits in 2014, according to a study released Tuesday by Lurie Children’s Hospital. The drop is even more significant because the fest was four days last year, compared to three in 2014.

When you add older underage attendees to the total, the number of emergency room visits for Lolla-goers between 13 and 20 still fell, to 128 last year, from 212 in 2014, the hospital said.

The numbers cover binge drinking only, said Julie Pesch, a hospital spokeswoman.

Luriecredits its own underage drinking awareness campaign as well as stricter Lolla policies for the drop, but maintains that binge drinking is still a serious issue for the big annual music festival in Grant Park.

The weekend is still the worst in the city for underage drinking, with a rate nine times higher than average, the hospital said.

Werecommend that parents talk about the risks of underage drinking with their kids, especially before concerts and events where alcohol will be present,” Dr. Nina Alfieri, the lead researcher on the study, said in a statement. “They should have their teenager check in with them throughout the day and make sure their children have safe plans for traveling home.”

RELATED: 10 Ways Lollapalooza Will Ruin Your Weekend, Whether You’re Going Or Not

The hospital said half the teenagers sent to an emergency room during last year’s Lollawere 16 to 18 years old and from outside Chicago. At 53 percent, teenage boys were more likely to go to the hospital than girls.

The hospital said Lollaadded more security to the gates last year to check teenagers’ bags for alcohol and other prohibited items. The festival also added a “Safety Team” of volunteer medical students in light blue shirts who blend into the crowd and can administer aid quickly.

A festival spokeswoman did not immediately return a message seeking comment.

This year’s Lollapalooza kicks off Thursday morning. Headliners include Chance The Rapper, Lorde, Blink-182 and Migos.

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Teen ER Visits During Lolla Dropped, But It’s Still Worst Drinking Weekend – DNAinfo

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