Enhancing Primary Care Access Through Community-Based Innovations

A critical challenge facing healthcare is the need to enhance accessibility and utilization of primary care and wellness services. Greater access to these essential services often leads to improved health outcomes, reduced reliance on acute care, and lower costs. Emergency department (ED) overutilization in the US is a significant issue, particularly among Medicaid enrollees, who often visit EDs for non-emergent care.

Several factors contribute to unnecessary ED visits, including:

• Lack of a relationship with a primary care provider or limited access to primary care.
• Lack of after-hours or timely access to a provider.
• Misunderstanding about when to seek emergency care.
• Barriers to access, such as transportation challenges.
• Gaps in care coordination among multiple providers.

Common reasons for unnecessary visits to the ED include conditions like bronchitis, cough, dizziness, flu, headache, low back pain, nausea, sore throat, and upper respiratory infections, all of which can typically be treated in a primary care setting.

In line with our mission to provide personalized, community-based services to those in need, we are developing innovative tools to improve access to and utilization of primary care services. These initiatives include:

• Implementing primary care provider (PCP) screening and AI-driven navigation tools.
• Screening for vaccinations and connecting clients with available resources.
• Creating educational content to inform clients about the appropriate use of urgent care services and vaccinations for flu, COVID-19, pneumonia, and RSV.

We're focused on developing solutions that eliminate barriers for our clients and connect them with a primary care provider. We also prioritize educating individuals on the importance and benefits of annual vaccinations, where they can receive them, and when to choose urgent care instead of the emergency department.

This initiative and our model for addressing health-related social needs will address the most common reasons for excessive emergency department utilization.

Learn more about our Path Assist intervention here.