10 Things You Need to Know to Succeed and Be Happy in an ACO

Leigh Page


July 28, 2015

In This Article

9. Patients Will Be More Likely to Avoid the ED

According to Dr Jacob, one easy way for ACOs to realize savings is to make sure physicians are taking same-day appointments, which require the office to keep open a certain number of slots. For one thing, same-day scheduling makes it more likely that patients will keep their appointments—one study[9] found it lowered no-show rates by 10%—and out of the ED. "This is one of the best ways to reduce ED visits," he says.

Dr Jacob says that whereas most PCPs at Northwest Ohio offer same-day appointments, many specialists do not, and in some cases, their offices are instructing patients seeking timely care to go straight to the ED.

"Sending patients to the ED doesn't make sense, because they're probably going to see an ED physician or a nurse practitioner who's not familiar with them," Dr Jacob says. And, in fact, they might not even need to be there. A 2012 study of ED patients[10] found that of those who weren't sick enough to require admission, about 20% said they came because their doctor told them to.

Rather than sending patients to the ED, Dr Jacob thinks specialists should refer them back to their PCPs, who understand their care and can usually see them on the same day. As a practicing internist, he's asked specialists to do this. "If I can avoid an ED visit, it's going to affect our ACO's bottom line," he says.


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