Reps. Rodriguez, Sanfelippo: Innovative healthcare pilot program becomes law

Contact: State Rep. Jessie Rodriguez, 608.266.0610
State Rep. Joe Sanfelippo, 608.266.0620

MADISON, Wis. – Legislation authored by Rep. Jessie Rodriguez, R-Oak Creek, and Rep. Joe Sanfelippo, R-New Berlin, was signed into law. The proposal encourages hospitals to adopt intensive care coordination, a pilot program intended to reduce Medicaid costs and improve care for patients that substitute the emergency room for primary care.

“Many emergency departments, especially in the greater Milwaukee area, are overburdened with emergency room visits from patients that would be better served by visiting a primary doctor,” said Rodriguez.

Intensive care coordination encourages hospitals to develop a team tasked with identifying patients, referred to as high utilizers, who frequently use the emergency room for primary medical care. High utilizers will be connected with a team of health experts responsible for finding more appropriate medical services for patients.

“This proposal will facilitate better care for these patients and reduce costs for hospitals and the state,” Sanfelippo said.

The program is expected to improve care by connecting patients with a primary physician who will become familiar with the patient’s medical history and reduce Medicaid expenses with fewer ER visits.

In 2016, more than 10,000 people visited emergency departments seven or more times at an estimated cost of $53.5 million. This small group accounted for 111,000 ER visits last year.

Similar programs at Aurora St. Luke’s and Sinai in Milwaukee, have demonstrated significant savings reducing overall emergency room visits by 44 percent over a six month period and by 77 percent over a 7-12 month period.

“Wisconsin has always been a leader when it comes to developing innovate methods that increase access to care while controlling costs. We are once again leading with this innovative program that has the potential to save the state millions of dollars in Medicaid costs and improve overall health care for MA patients,” said Rodriguez.

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