Group Health Cooperative of South Central Wisconsin, a non-profit managed care provider, launched a data-mining project last year to cut costs for services provided outside of its own clinics. Among 17 potential targets that the group identified was what became known as "emergency room frequent fliers"--just 98 of the cooperative's 62,000 members who visited ERs more than six times a year, racking up charges of $2.2 million.
The cooperative's Care Management and Community Services departments contacted each of the frequent fliers and discovered that many didn't understand the importance of having a primary healthcare provider. They also didn't know about the company's urgent care facility, a lower-cost alternative to the emergency room. In the program's first six months, costs associated with ER frequent fliers decreased by $481,000.