The Real Story Behind Michigan’s Avoidable ER Visits

Blues Perspectives

| 3 min read

Mother taking sick son's temperature at home
When you get hurt or a loved one is sick, a natural tendency is to fear the worst. A stomachache turns into appendicitis; ankle pain means a broken bone. It doesn’t help that searching for information about symptoms online can lead you down a scary rabbit hole. With all that fear, it’s no wonder that people’s instinct is to rush themselves to an emergency room—especially if it’s late at night or on a weekend, when typical doctors’ offices are closed. In 2016, Commercial and Medicare Advantage PPO Blue Cross Blue Shield of Michigan members visited the emergency room 672,000 times. Based on an algorithm for avoidable ER visits, roughly 44% of the visits were, to varying degrees, avoidable. Just three years later in 2019, the number of avoidable ER visits dropped to 520,000. But while emergency room visits are crucial if you’re experiencing a life-threatening condition, most of the time there are better options. Your primary care physician is an excellent option for preventative care, to address symptoms early and effectively. The Blue Cross Blue Shield 24-hour Nurse Line can get your health questions answered fast and can provide general wellness information and support no matter what time of day. Urgent care centers are also available for a wide range of treatments—perfect for when you can’t find a suitable opening in your doctor’s schedule. Here are just some of the reasons an urgent care center can get you feeling better, faster:
  • You don’t need appointments—just walk in the door and get help.
  • They are usually located close to home.
  • You’ll receive high-quality care from board certified doctors much more quickly than if you went to an ER.
By utilizing options like the 24-Hour Nurse Line or urgent care centers, members save time and money on costly ER visits. Not only are ER visits more expensive (the average claim cost for each visit is $1,383), but they can also be lengthy, which potentially means lost time at work and lower productivity. The difference between 2016 and 2019 avoidable ER visits data demonstrates the effectiveness of Blue Cross efforts to reduce avoidable Emergency Room utilization among PPO members. Over 150,000 fewer visits (22.6%) occurred in 2019, compared to 2016, and a lower percentage of those visits were, to varying degrees, deemed avoidable. When you’re in the middle of a health scare and in extreme pain, you likely won’t want to take the time to find the nearest urgent care center. That’s why it’s important to research that now at bcbsm.com/findcare to see all the options near where you work and live. Then, when something happens, you’ll know how to get the fastest care possible. You can also access the 24-hour Nurse Line: 1-800-775-BLUE (2583) for Blue Cross Blue Shield of Michigan members and 1-855-624-5214 for Blue Care Network members. For more about how an urgent care center can help you feel better, read these other blogs:
MI Blues Perspectives is sponsored by Blue Cross Blue Shield of Michigan, a nonprofit, independent licensee of the Blue Cross Blue Shield Association