2016 Regular Session APPROVED
SENATE CONCURRENT STUDY REQUEST NO. 2
BY SENATOR GATTI
A CONCURRENT STUDY REQUEST
To request the Senate Committee on Health and Welfare and the House Committee on
Health and Welfare meet and function as a joint committee to study and hear
testimony on the Senate Resolution No. 29 of the 2014 Regular Session of the
Legislature work group report on strategies to decrease primary care utilization in
emergency rooms and hospitals across Louisiana.
WHEREAS, in the 2014 regular session of the legislature, Senate Bill No. 493 was
filed to prohibit advertising of emergency room wait times by a hospital, as defined in R.S.
40:2102; and
WHEREAS, in an attempt to reach a compromise on this matter, the author filed
Senate Resolution No. 29, directing the Department of Health and Hospitals to create a work
group to develop strategies to decrease primary care utilization in emergency rooms; and
WHEREAS, the department established an "ER is for Emergencies" work group,
consisting of representatives of the Louisiana Hospital Association, Bayou Health plans,
Louisiana Behavioral Health Partnership Statewide Management Organization, Louisiana
Health Care Quality Forum, Louisiana Nursing Home Alliance, Louisiana Chapter of the
American College of Emergency Physicians, Louisiana State Medical Society, Louisiana
Chapter of the American Academy of Pediatrics, Louisiana Ambulance Alliance and
Louisiana Association of Health Plans; and
WHEREAS, the work group met weekly from April 23, 2014, through the fall of
2014; and
WHEREAS, in February 2015, on behalf of the work group, the department
submitted a report to the legislature that included five strategies that the membership agreed
upon to decrease primary care utilization in hospital emergency departments; and
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WHEREAS, the five strategies were:
(1) Establish an electronic ED Visit Registry to provide timely notification
of Medicaid members' ED use to Bayou Health plans.
(2) Develop and implement a communications plan to educate patients on the
appropriate use of hospital EDs and alternate access points to care.
(3) Develop and issue prescribing recommendations to discourage narcotic
seeking in hospital EDs.
(4) Promote use of the Louisiana Board of Pharmacy's Prescription
Monitoring Program to identify potential narcotic seekers in the ED.
(5) Develop baseline and progress measures for quarterly reporting on the
implementation of agreed upon strategies. These measures are hospital participation
in the ED Visit Registry, the completeness of data reported to the ED Visit Registry,
accuracy of Medicaid member identification from the ED Visit Registry, pre-ED
visit primary care contact rate, post-ED visit follow up rate, and the number of ED
visits per 1,000 member months; and
WHEREAS, in its closing paragraph, the department reported being "optimistic about
the potential for the strategies developed by the SR 29 Working Group to reduce ED
demands and constrain Medicaid expenditure growth"; and
WHEREAS, it has been more than two years since the work group first convened and
it is unclear whether these strategies have been implemented or, if implemented, what the
outcomes have been; and
WHEREAS, primary care use of the emergency department continues to be a
significant problem, with some hospitals now even offering website links or apps to
"check-in" or book your emergency room visits in advance; and
WHEREAS, this emergency room misuse translates into inappropriate and more
costly care at a time when the state budget is already strapped; and
WHEREAS, Senate Bill No. 38 of the 2016 Regular Session of the Legislature was
filed to address the reimbursement rate for emergency room treatment for non-emergency
services; and
WHEREAS, it is appropriate to conduct a hearing so that the parties who developed
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and agreed upon the Senate Resolution No. 29 strategies could present an update to the
committees on the status of implementation of each strategy, explain any impediments to
implementation, and offer any constructive alternatives to address this critical issue.
THEREFORE, the Legislature of Louisiana requests that the Senate Committee on
Health and Welfare and the House Committee on Health and Welfare meet and function as
a joint committee to hear testimony on the Senate Resolution No. 29 work group report on
strategies to decrease primary care utilization in emergency rooms and hospitals across
Louisiana; and that the joint committee report its findings to the legislature prior to July 1,
2016.
A copy of this Study Request shall be transmitted to the Department of Health and
Hospitals, Louisiana Hospital Association, Bayou Health plans, Louisiana Behavioral Health
Partnership Statewide Management Organization, Louisiana Health Care Quality Forum,
Louisiana Nursing Home Alliance, Louisiana Chapter of the American College of
Emergency Physicians, Louisiana State Medical Society, Louisiana Chapter of the American
Academy of Pediatrics, Louisiana Ambulance Alliance and Louisiana Association of Health
Plans.
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