Emergency Room Utilization Management

The Carolina Community Health Partnership Network of Cleveland County and Rutherford County work in collaboration with the primary care physicians and Medicaid enrollees/ HealthChoice enrollees to ensure that the use of the emergency room is appropriate. Network case managers and provider offices strive to continually educate patients on use of their medical home ( Children and Adults) and appropriate use of the emergency room.

The Carolina Community Health Partnership Network has a case manager located in the emergency room at Cleveland Regional Medical Center who meets with Medicaid and HealthChoice patients after their emergency room visit.

Case Manager provides:

  • management information for Medicaid and HealthChoice patients,
  • confirms discharge instructions are understood by patients
  • coordinate ER referrals to specialists,
  • makes follow-up appointments with PCP's and/or specialists including Dentist,
  • educates patients on correct usage of emergency room and medical home,
  • makes referrals to other CACM when patient's condition requires monitoring after discharge from ER,
  • alerts PCP offices when patient over uses ER for non-emergent issues.

All providers are encouraged to educate patients on the concept of medical home. For any referral or questions about emergency room utilization, please contact case management services

 

Resources

- The Right Call Every Time: Colds, Flu, and Other Infections
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The Right Call Every Time: Medical Home VS. Emergengy Room
- The Right Call Every Time: Make each doctor's visit work for you!
- The Right Call Every Time: Low Back Pain
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The Right Call Every Time: Headaches
- The Right Call Every Time: Urinary Tract Infections
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Community Care NC