Aurora Health Care Inc.
Studies show that approximately 5 percent of health care patients account for nearly a quarter of all emergency department visits nationwide.
These “high utilizers” either don’t know how to navigate the health care system or don’t have access to other means of care.
Approximately 700 emergency department “high utilizers” have been identified in the Milwaukee area. It can be an expensive way to receive care, but for many, it’s all they know.
To break the cycle, Aurora Health Care Inc. has implemented its Coverage to Care program, which takes a comprehensive case management approach to individual care. Social workers team up directly with emergency department high utilizers to determine the factors contributing to their utilization rate.
Aurora staff works with patients to educate them on the health care system, and to understand the social and environmental issues that impact the patients’ ability to take a proactive approach to their health care.
The program, first launched at Aurora Sinai Medical Center in Milwaukee, was quickly expanded to Aurora St. Luke’s Medical Center, as well. Aurora saw a 39 percent decrease in emergency visits by Coverage to Care patients at Aurora Sinai and a 68 percent decrease in visits at St. Luke’s.
The Coverage to Care program strives to educate and advocate for proper use of the health care system.
Once patients have successfully navigated the health care system for six months with the help of a social worker, they are transitioned out of the program with the knowledge of how to appropriately and cost effectively manage their own care.