Objective. To test interventions to decrease the utilization of hospit
al emergency departments (EDs) for routine, nonemergent health care am
ong Medicaid recipients. Methods. Families of a Medicaid-recipient chi
ld presenting to a children's hospital ED for nonurgent problems recei
ved information from either a health professional or a clerical employ
ee about the importance of a primary care provider and assistance with
making an appointment to the provider of their choice. The health pro
fessional continued to work with her assigned families in eliminating
barriers to appropriate utilization of a primary care provider for up
to 3 months after the index ED visit. A third (comparison) group recei
ved no intervention. Subsequent health care utilization for each enrol
lee was tracked via Ohio Medicaid claims data throughout the four subs
equent 6-month periods after the index ED visit. Results. Children in
the intervention groups had 11.1% and 14.5% fewer nonurgent ED visits
in the 6 months after the index ED visit with a concomitant decrease i
n cost for this type of care when compared with the comparison group d
uring the same time period. No difference in the number of preventive
or ill-child primary care visits was seen. There was no difference in
health care cost or utilization in the time period 6 to 24 months afte
r the intervention. Conclusions. Interventions in pediatric EDs aimed
at decreasing subsequent ED utilization for nonurgent care can be effe
ctive, resulting in modest decreases in the cost of health care for a
Medicaid population.