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While lower emergency department (ED) costs are the main goal of LA Health Care Plan’s auto-authorization pilot project, researchers at the Los Angeles network also will be measuring several other outcomes (for a breakdown of the survey report, see p. 53):
• unacceptable clinical outcomes;
• unacceptable clinical outcomes attributable to the model;
• utilization trends, including overall levels of utilization and global costs (little or no impact on costs would be quite acceptable, if other outcomes are favorable);
• member, ED, primary care physician, and plan satisfaction, based on specific survey tools;
• reductions in repeat visits for members and their families;
• an increased number of preventive services for members and their families;
• an increased percentage of completed post-ED follow-up visits with the member’s primary care physician (PCP);
• a reduced rate of PCP/Plan transfers;
• reduced ED use by LA Care members at the pilot site over time.