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Case Study

How InterMed lowered ED utilization by investing in primary care access

15 Minute Read

Key Takeaways

The challenge

Avoidable ED utilization often stems from poor primary care access as patients are forced to seek necessary care elsewhere. However, many organizations fail to make the necessary investments upstream in primary care to improve access and give patients a viable alternative to the ED.

The organization

InterMed is a 90-physician, largely primary care independent medical group located in Portland, Maine. They provide some specialty services, including cardiology, OB/GYN, and sports medicine. InterMed also offers seven-day-aweek urgent care and extended primary care hours on the weekend.

The approach

InterMed lowered ED utilization by investing in access and steering patients to their urgent and primary care rather than the hospital. To connect patients to their primary care services, they stood up a centralized call center and tracked utilization data to identify patients who sought care elsewhere. They also embedded patient education throughout their triage process to make sure patients understand the care they can get from InterMed.

The result

By investing in primary care access and giving patients an alternative to the ED, InterMed was able to significantly reduce their ED utilization. According to one of their largest payers, InterMed has the lowest ED utilization rate in Maine, and the 4th lowest rate in the country.



How InterMed invested in primary care access to lower ED utilization

To lower ED utilization, InterMed focused upstream to improve primary care access and give patients an alternative to the ED. They set up a seven-day-a-week urgent care center staffed by emergency medicine physicians and extended primary care hours to include the weekend. Then, using analytics, triage, and patient education, InterMed directed patients away from the ED and toward their own services.


The three initiatives

To expand primary care access and ultimately lower ED utilization, InterMed focused on three main initiatives:

  • Initiative

    Track utilization data to direct patients back to primary care

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  • Initiative

    Equip urgent care to see higher acuity patients

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  • Initiative

    Triage patients to the right site of care

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Prioritizing access reduces avoidable ED utilization

As a result of these initiatives, fewer InterMed patients visit the ED, and many more opt to receive care at InterMed’s primary care and urgent care centers. Below, we’ve included a table that summarizes the impact this has had on ED utilization (per 1,000 patients).

By building out their primary care footprint and data capabilities, InterMed has significantly lowered their ED utilization rate. They now have the lowest ED utilization rate in the state, and the 4th lowest in the entire country, according to their largest payer.


“Hospitalization for Potentially Preventable Complications (HPC)”, The National Committee for Quality Assurance, 2020.

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