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Md. nonprofit receives grant to reduce ER visits at Sinai

Sometimes, it’s a migraine. Sometimes it’s unmanaged emphysema. Other times, it’s just a common cold.

People end up in a hospital emergency department with all sorts of complaints that would be better handled elsewhere, but redirecting those patients to the proper setting can be tricky.

That’s why HealthCare Access Maryland (HCAM), a nonprofit, teamed up with Sinai Hospital to identify frequent ED visitors and connect them with the knowledge and tools they need to take better care of themselves without knocking on the hospital’s doors, officials said.

HCAM and Sinai received a three-year, $800,000 grant from the state to launch the program, dubbed “Access Health,” which kicked off in early June. Officials from the two organizations on Wednesday formally announced the program, which is funded by the Maryland Community Health Resources Commission.

“A lot of people are used to always going to the emergency room, so we are coaching them on how to think about what to do when you have a true medical emergency and what to do when you have something that could be managed either on your own or with the assistance of a community provider,” said Nakia Abrams, director of the Access Health program.

When a patient is identified as a frequent user of the emergency department, HCAM will deploy a case manager, or “care coordinator,” to work with that individual for 90 days after he or she is discharged from the ER.

Sinai has already identified about 200 people who have visited the ER more than four times in four months. The hospital recommended about 70 people so far for the program, which is voluntary, and 48 patients have enrolled so far.

The goal is to slash the number of unnecessary emergency room visits by teaching those patients about alternative health care options — such as regular checkups with a primary care provider — and helping them actually follow through on the new strategies.

For example, some patients still don’t know how to enroll in health insurance or how to find physicians who participate in their insurer’s network, Abrams said.

Others miss appointments — or don’t schedule them at all — because they can’t find transportation or child care. Some have underlying mental health issues that need to be addressed, Abrams said, while others simply can’t afford their prescriptions.

“There’s a lot of education involved and a lot of hand-holding, to be honest,” Abrams said. “Whatever the resource is that will help solve [the patient’s] problem, we connect them to it.”

Others community groups and health systems across the state are trying similar programs to reduce the strain on emergency departments and save money by helping people find more appropriate, and less expensive, care.

These programs align with recent state and federal goals to reform the way hospitals get paid and the kind of care they provide, said Dr. William Jaquis, a member of the Maryland Community Health Resources Commission and the chief of emergency medicine at Sinai.

“This is the sort of project I’ve envisioned for many years,” he said.

Since the commission was created in 2005, it has awarded nearly $42 million in grants to groups across the state.