Down coding this list of so called preventable visits will absolutely harm patients on many levels including fear of coming to the ED - we are already seeing that the patients who tried to avoid  the ER during the COVID19 pandemic are coming in grudgingly but are much more in extremis and sicker than if they had come in sooner. In addition, with shifts towards tele health visits, we are often the only people who can do a physical exam on these people to determine if an emergency exists. This program will only serve to harm physicians, ERs and patients. You can and should do better.