We want people to car pool, so we create HOV lanes. We don’t want them to smoke, so we tax cigarettes and raise the age to purchase tobacco. Society has all kinds of incentives and penalties to encourage people to do the right thing.
In health care, we have many choices of places to seek routine as well as urgent health care. Some are easier to access because of their hours or proximity. There are also big cost differences depending on the type of facility we choose. We know that making it easier for patients to seek the right care at the right place is the first step toward reducing health care costs and improving patient outcomes.
Doctors’ offices are starting to offer expanded hours and walk-in availability; health systems and insurers are offering telehealth visits with a nurse or physician for time-sensitive but less complex needs; and we’ve seen urgent care centers as well as retail clinics in drug store chains open throughout New Jersey.
Besides the obvious hours of availability, there is still a bit of mystery about what each location will cost patients and whether it is the appropriate place for the care they need.
To learn more how consumers are navigating their options, the Quality Institute partnered with Rutgers Eagleton Center for Public Interest Polling. We wanted to learn where New Jerseyans seek care — and what might prompt them to find alternate settings.
Our poll findings, announced yesterday, were both troubling and encouraging. What concerned me? Our poll found that eight percent of New Jerseyans obtain all their care from hospital emergency departments. Hospital ERs are not designed for routine care or for care of chronic conditions, such as diabetes and heart disease. And the hospital ER is the most costly setting on the planet. This poll finding tells me that we have to redouble our efforts to improve access and community engagement to connect people to Community Health Centers and private health care providers. And, more troubling, if people lose their insurance due to an ACA repeal, the percentage of people seeking care in the ER will increase.
We also found that 46 percent of people use urgent care centers some of the time and three percent use the centers all the time. It was encouraging that the poll found that more consumers are open to seeking care from urgent care centers rather than an emergency department if they can reduce their wait times and out-of-pocket expenses and also spend more time with the health care provider.
One of the reasons we conducted the poll was to understand what factors would motivate people to seek care at different settings, especially now that we have the lowest uninsured rate in the past three decades. We found that lower income patients tend not to seek care in urgent care centers but are very open to doing so. Perhaps we could decrease ER visits if more of these facilities accepted Medicaid. That’s an area our lawmakers can examine, and we hope they will be informed by our poll.
To further understand where people are getting care and how they make their choices, last month we released our poll on telehealth. We want people in New Jersey to be able to receive care in the most convenient, cost-effective way without sacrificing on quality. That may mean obtaining a prescription for birth control through an online clinician “visit” or skyping a clinician to receive a prescription for poison ivy. Our poll found a willingness among many New Jersey residents to use telehealth. We hope to see benefit plans cover telehealth, and we also need sensible regulations that support the expansion of telehealth and give consumers what they want.
Every day we face choices. The expansion of health care choices along with smart policies should make it easier for us to get the right care at the right place — on our schedule. Our busy lives extend well beyond a 9 to 5 day. Our polls told us that Garden State residents are open to options such as telehealth and urgent care centers instead of the ER.