ER LIGHT: How Patients Get Emergency Care at a Fraction of an ER Visit or Hospital Stay

Picture it: An elderly oyster farmer shows up to the doctor in Wilmington, N.C., with his hand red and swollen from a wound – a clear infection. Typically, this would mean a trip to the ER and probably a few days of hospitalization for IV antibiotics to make sure the infection does not advance. And of course, a costly bill would follow. It’s a common scene across the country, happening in countless ERs to a myriad number of senior patients.

Instead, our oyster farmer was treated at Wilmington Health’s “Today’s Care Plus,” or what’s called an “extensivist clinic” – a growing trend in value-based care that is offering patients hospital-level care as an outpatient, so they can spend their nights in the comfort of their own homes. agilon health is helping its physician partners like Wilmington Health accelerate into value-based care models that foster these important new health clinics.

What exactly is an extensivist clinic?

Sometimes referred to as “ER light,” extensivist facilities offer more than urgent care and can treat many conditions that otherwise require hospital treatment. Most importantly, these clinics keep patients out of emergency rooms and help save costs. Here’s a look at some of the common conditions they can treat without an ER:

• IV diuretics for chronic heart failure
• IV steroids for COPD
• Nebulizer treatments for asthma
• IV antibiotics
• Suturing wounds
• Imaging and lab work
• Infusion therapy

“Our oyster farmer patient received an IV antibiotic and we were able to send him home that evening, with orders to return for a recheck the next morning,” explains Dr. David Schultz, a primary care physician at Wilmington Health’s Today’s Care Plus. “When his hand did not look worse, we then continued to monitor the infection virtually – giving him a full course of treatment that cost a fraction of an ER visit and avoided hospitalization.”

A Model Approach

Wilmington Health is not the only agilon health physician partner finding success with the extensivist model. At Central Ohio Primary Care, the nation’s largest practice of independent physicians, Dr. Kris Oaks had a 92-year-old patient with a stomach bug. The practice’s ER diversion team sent the patient to the extensivist clinic, which gave her IV fluids to rehydrate and fight the nausea. The patient remained at the clinic until it closed at 9 p.m., went home to sleep in her own bed, and returned the next day for further treatment. After 36 hours of careful monitoring, she was through the worst and able to recover on her own.

The cost-effective extensivist clinic kept Dr. Oaks’s patient away from the potential trauma and confusion of an ER visit, and better yet, helped her avoid potential exposure to hospital infections – a vital consideration for a 92-year-old senior.

Extensive Benefits and Lower Costs

Since these centers are integrated into primary care offices, patients receive coordinated, streamlined care that benefits from the long-standing relationship between primary care physicans and patients. This approach also creates a much better patient experience, helping seniors avoid the emergency room and possible hospitalization, which can sometimes introduce other health risks like infection.

Finally, there are significant cost savings to both the healthcare system and the patient. Extensivist care costs a fraction of an ER visit or hospital stay.

These clinics underscore how agilon health and its physician partners are investing resources that make a tangible difference in the way care is delivered to older adults, while also fostering value-based care that benefits the entire healthcare system.