Using Chronic Care Management Visits to Reduce the Number of Frequent Emergency Department Visits

This pilot study aimed to reduce the number of avoidable Emergency Department (ED) visits by enrolling the top 50 super-utilizing patients into a Chronic Care Management Program. Patients received monthly telehealth visits addressing concerns, chronic medical conditions, barriers to care, and social determinants of health. The study found a statistically significant decrease in the frequency of avoidable visits after the intervention. While there was a non-statistically significant difference in the cost of avoidable visits, the results indicated a positive impact on reducing avoidable ED visits. This approach, targeting super-utilizers and addressing social determinants of health, demonstrates the potential for improving patient care and reducing healthcare costs.