• Maria C Raven, Scott M Kotchko, and David A Gould.
• UCSF Department of Emergency Medicine, San Francisco, CA 94143, USA. maria.raven@emergency.ucsf.edu
• Am J Manag Care. 2013 Jan 1; 19 (1): 41-5.

ObjectivesTargeted messaging that encourages consumers who are frequent users of the emergency department (ED) to contact their primary care physician in advance of an ED visit could reduce healthcare expenditures in select populations. However, such messaging has not been thoroughly evaluated. We used the input from consumers in a capitated plan to develop and test messaging designed to encourage primary care physician (PCP) contact prior to an ED visit.Study DesignCross-sectional study of managed care plan members with frequent ED use in Brooklyn and the Bronx.MethodsQualitative interview and quantitative phone survey methods were used to develop and test a variety of messages designed to encourage consumers to contact their primary care practice prior to an ED visit. Linear regression analysis determined which tested messages were most highly correlated with increased likelihood of primary care practice contact in advance of an ED visit.ResultsHealth plan member interviews led to the development of multiple messages. The message that tested most successfully underscored "time and stress" inherent in an ED visit that could have been avoided by contacting one's PCP in advance via a convenient 24-hour call line.ConclusionsA simple message that challenges consumers to think about whether the ED is truly more convenient and that provides a simple mechanism for finding out whether a trip to the ED is necessary (primary care practice contact) holds promise as a mechanism to reduce ED use for those who have ready access to primary care.

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