How Payers Can Reduce Emergency Department Admission Rates, Costs

Health Payer Intelligence August 9, 2023
By Kelsey Waddill

To reduce emergency department admission rates, payers can implement virtual care, machine learning, and value-based care strategies.

Members and payers do not always see eye-to-eye, but one point on which they closely align is their desire for members to stay out of the emergency department.

Emergency department visits are associated with higher healthcare spending. A single trip to the emergency room costs $2,453, on average, under a large employer-sponsored health plan. The out-of-pocket costs can range from $128 or less to more than $907.

And, in recent decades, evidence indicates that these costs are only growing.

Emergency department services account for a small share of overall health system spending, absorbing 3.2 cents out of every healthcare premium dollar. But current...

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