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Emergency Room Utilization Reduction Pilot Program (IB 25-2)

Date: 01/31/25

Louisiana Healthcare Connections is sharing with providers a pilot program to reduce emergency room utilization (IB 25-2).

The Louisiana Department of Health (LDH) announces an emergency room (ER) utilization reduction pilot program for 12 parishes comprising Region 4 (Lafayette area) and Region 5 (Lake Charles area). The program works by extending a primary care physician’s (PCP) practice into patients’ homes, offering treatment at home and providing the ability to address nonmedical drivers of health. To accomplish this, LDH has partnered with its six Medicaid managed care organizations (MCO) and Acadian Health to implement the program effective February 10, 2025. It provides mobile urgent treatment to patients, age 13 and older, for a wide array of non-life-threatening medical conditions with the intent of avoiding an unnecessary ER visit. The hours of operation are Monday through Sunday, 8 a.m.-10 p.m.

Acadian Health will be delivering a two-path program:

1. Acute Care at Home is an on-demand service for patients who require same day care within one hour. It serves as alternative care for non-traumatic hospitalizations for sick but stable patients who would otherwise seek care at the ER.

How it works:

  • A patient who is reporting an acute exacerbation of chronic disease is referred to Acadian Health by their provider, and an initial visit is scheduled.
  • Once arriving on scene and conducting a comprehensive patient assessment, Acadian Health communicates with the PCP to report findings and request direction for care.
  • Treatment is ordered, administered, and results and records are made available to the patient’s PCP through Acadian Health’s electronic health record.

2. Clinic at Home is a proactive visit which is scheduled in advance, usually 24 hours ahead of time. This allows providers to extend their specialty practice into patients’ homes, offering after hours and weekend support and the ability to address non-medical drivers of health.

How it works:

  • MCOs identify patients who qualify for the program, obtain patient consent, and notify patient's PCP. Patients are enrolled via Acadian Health's online portal.
  • The initial visit is completed, including all assessments and screenings, to identify needs, and a second visit is scheduled.
  • Acadian Health connects with patient’s case manager to coordinate plan and community resources to address patient needs and goals of care.
  • Treatment is ordered, administered, and results and records are made available to the patient’s PCP through Acadian Health’s electronic health record.

Acadian Health’s services include assessment, treatment, and administration of medication. In addition to helping extend a provider’s practice into a patient’s home, the physician collaborating care will be reimbursed for the applicable evaluation and management telehealth visit.

For more information such as a full listing of services provided, parishes served, and reimbursable procedure codes visit https://ldh.la.gov/healthathome.

For more information: (337) 291-3333 or (800) 259-3333.

For providers to schedule an Acute Care at Home visit for their patients: (337) 704-5829 or (844) 987-1395.