Reduce Avoidable ED Referrals

Distillemr helps health plans reduce avoidable medical utilization by improving the clinical decisions that drive it—at zero risk to the plan.

We analyze encounters retrospectively to identify potentially avoidable emergency department referrals, unnecessary testing or referrals, and other opportunities to improve care—then turn those findings into targeted, individualized feedback for clinicians. No new point-of-care alert, workflow interruption, or administrative burden.

Illustrative example

Small changes in clinical behavior, meaningful savings

The opportunity is in provider groups where a few better decisions a day add up. Consider an urgent care organization sending 60 patients to the emergency department each day.

60

patients sent to the ED each day

3

fewer transfers a day, safely avoided—just 5%

~1,100

fewer ED visits a year, with the downstream costs that come with them

Illustrative arithmetic (3 visits × 365 days). Actual results depend on the provider group, baseline, and the measures agreed with the plan.

How it works

From individual charts to sustained changes in how clinicians decide.

1

Identify potentially avoidable transfers

Retrospective review of encounters flags which ED referrals appear potentially avoidable—without touching care in the moment.

2

Find the recurring patterns

Distillemr determines the clinical patterns behind those transfers, so interventions target root causes instead of one chart at a time.

3

Deliver focused interventions

Clinicians receive targeted, individualized feedback on the decisions that matter—outside the point of care, with no added alerts or administrative work.

4

Measure what changes

Utilization is tracked over time against the baseline, so everyone can see whether clinician behavior—and cost—actually moved.

For health plans

Paid for outcomes, not software utilization

We structure payer partnerships around measurable outcomes. Distillemr can put its fees substantially or entirely at risk.

1

Establish a baseline

Start from the provider group's current ED referral and utilization patterns.

2

Agree on the measures that matter

Define the utilization and quality measures together up front—so savings never come at the expense of care.

3

Demonstrate improvement

Show measurable change against the baseline over a defined period.

4

Share in the savings

Distillemr participates in savings only when measurable value is created.

Why this matters

Not more data and dashboards—a mechanism for turning data into better decisions.

Lower total cost of care

Relatively small, sustained changes in clinical decisions translate into meaningful downstream savings.

Zero risk to the plan

With fees at risk and tied to agreed measures, the plan pays for demonstrated results rather than software seats.

No added clinician burden

Feedback arrives outside the visit—no new point-of-care alerts, workflow interruptions, or administrative tasks.

Sustained behavior change

Individualized feedback addresses the recurring patterns behind utilization, so improvement lasts beyond a single campaign.

Support for value-based providers

A scalable way for payers to help value-based provider organizations improve—not just monitor them.

Beyond the ED

The same approach applies to unnecessary testing, unnecessary referrals, and other opportunities to improve care.

Who it's for

Health plans & payers Value-based provider organizations Urgent care groups Primary care groups

Frequently Asked Questions

No. Distillemr analyzes encounters retrospectively and delivers feedback to clinicians afterward. It adds no alerts or interruptions during the visit, and clinicians keep full judgment over every decision at the point of care.

The goal is to safely reduce avoidable referrals. Quality measures are agreed alongside utilization measures before the work begins, and findings are used to help clinicians learn from patterns—not to set rules about who can or can't be sent to the emergency department.

Distillemr can put its fees substantially or entirely at risk. Together we:

  • Establish a baseline for the provider group
  • Agree on the utilization and quality measures that matter
  • Demonstrate improvement over a defined period
  • Share in savings only when measurable value is created

Groups where relatively small changes in clinical behavior translate into meaningful savings—for example, urgent care organizations with high daily ED transfer volumes, and value-based provider organizations working to lower total cost of care.

No. ED referrals are a clear starting point, but the same approach identifies unnecessary testing, unnecessary referrals, and other opportunities to improve care and reduce avoidable utilization.

Book a call below. We'll discuss which provider group to start with, what baseline data is available, and the utilization and quality measures that would define success.

Explore an Outcomes-Based Partnership

Start with one provider group, agree on the measures, and share in savings only when value is created.

Book a Call