Cost Driver Spot Analysis: Avoidable ED Use

ED use as a cost driver analysis report cover
November 2015

Contact: Cari Frank
Email: cfrank@civhc.org

A cost driver analysis based on commercial health payer data in the Colorado All Payer Claims Database (CO APCD) shows that Colorado could save an average of $1,150 per visit and over $800 million annually if patients used a clinic or doctor’s office for non-emergent situations.   

The report also identifies staggering cost differentials between non-urgent health issues seen in an ER versus an outpatient setting such as a physician’s office or urgent care center:   

-Common cold - $709 versus $114
-Acute Bronchitis - $999 versus $126
-Sore Throat - $929 versus $131
-Backache - $1,337 versus $188 
-Headache - $2,010 versus $375 

According to the 2015 Colorado Health Access Survey (CHAS), roughly 40 percent of Colorado’s ER visits occur for non-emergent reasons. Given the estimated 1.8 million visits to Colorado’s ERs annually, that equates to roughly 720,000 potentially avoidable visits and substantial cost savings.   
 

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