Healthcare Law Blog

Kentucky Selected To Participate in ER “Superusers” Program

If you have ever visited an emergency room in the Commonwealth, chances are that you have seen a “superuser” – a person who uses the emergency room for regular health care instead of opting for a lower-cost alternative such as a primary care physician.  Whether Medicaid recipients or uninsured, superusers (also known as “super-utilizers” or “frequent flyers”) increase Medicaid expenditures and drive up the overall costs of health care.  In 2012, 4,400 Medicaid recipients used an emergency room ten or more times, and Kentucky Medicaid spent more than $219 million on emergency room use.  Superusers, however, do not just waste money.  They also waste the valuable time and resources of emergency room providers, creating longer wait times for those experiencing true emergencies.

Kentucky joins five other states (Alaska, Colorado, New Mexico, West Virginia, and Wisconsin) and Puerto Rico in a collaborative effort to design and improve state-level health systems for superusers.  The participants will take part in a “policy academy” – a team-based, multi-state process designed to help states develop and implement action plans to address complex public policy issues.  The policy academy will look at each state’s regulatory environment, workforce, finance structures, and data systems in their efforts to better coordinate services tailored specifically for this demographic.

The National Governors’ Association chose Kentucky to participate in this collaborate effort, for which funding is provided by the Robert Wood Johnson Foundation and the Atlantic Philanthropies.  Governor Beshear, who made the announcement on July 17, hopes to “build a healthier future for Kentucky” by participating in the program.  It is expected that the Medicaid expansion and new state health exchange will result in an additional 600,000 Kentuckians seeking care in the Commonwealth.  We must make every effort to ensure that these individuals seek the right type of care for their medical needs if we want our state’s health care programs to run efficiently and effectively.

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This article does not constitute legal advice.