Of course, with fee-for-service payment still dominating, reducing admissions can have a negative effect on finances, says Wilber, but Summa as well as other organizations should keep their eye on what's best for the patient over short-term economic pain.
"At this point, we want to move toward value-based reimbursement and care delivery and yet we're not fully there. When we reduce readmissions, the health plan and ACO think it's great. But understandably, the hospital CEO doesn't think it's great," he says.
"I think that we realize that simply admitting every patient who presents to the ED who is older is not the best way to deliver healthcare moving forward. No matter how things shake out with value-based purchasing, we still have to make the commitment to the right care, at the right place, and at the right time."
Although Summa spent $85 million on redesigning and renovating its EDs system-wide, developing a senior ED doesn't have to require a lot of investment, Wilber says. And it's still a new program, but Wilber thinks Summa's results should push more senior executives and CMOs to investigate what it would take to innovate ED services at their own facilities.