Emergency Room Decision Support

Reduce unnecessary emergency room visits

Fifty-five percent of emergency room (ER) visits are for non-emergent situations.1 Optum™ Emergency Room Decision Support is a service that engages health plan members after each emergency room visit to address factors that drive inappropriate ER use.

Emergency Room Decision Support personnel at Optum call members to reinforce the primary care provider relationship, educate them on ER alternatives such as Optum™ NurseLine(SM) services, and refer individual members to their health management program, if needed.

  • Identifies and engages individuals after each emergency room visit – up to five times during the course of a year
  • Leverages both “live” nurses and automated voice call technology to engage consumers
  • Refers to case and disease management programs and behavioral health services
  • Connects individuals with primary care providers (appointment scheduling too)  

Individuals who were engaged by ER Decision Support had a decrease in avoidable ER visits, while individuals who did not participate had an increase in avoidable visits.2   

1 Mercer Global Investments, February 2007
2 UHC fully insured claims analysis, 10/2007-06/2008