Med­i­caid pa­tients’ use of ER may be ex­ag­ger­ated: re­port

Modern Healthcare - - LATE NEWS -

The be­lief that Med­i­caid en­rollees overuse hospi­tal emer­gency de­part­ments for rou­tine care may be over­stated, ac­cord­ing to a re­port by the Cen­ter for Study­ing Health Sys­tem Change. The authors add that, while bet­ter-man­aged pri­mary care is of­ten cited as a so­lu­tion to ED overuse, many pri­mary-care of­fices are not equipped to han­dle mi­nor but still ur­gent cases as quickly or ef­fec­tively as a hospi­tal emer­gency depart­ment. The re­port also sug­gested that hos­pi­tals may be ex­ac­er­bat­ing ED overuse prob­lems by seek­ing to draw peo­ple into their de­part­ments with bill­board ad­ver­tis­ing and elec­tronic mes­sages that high­light the de­part­ments’ short wait times. Us­ing emer­gency depart­ment data from the Na­tional Cen­ter for Health Sta­tis­tics’ 2008 Na­tional Hospi­tal Am­bu­la­tory Med­i­cal Care Sur­vey pub­lic files, cen­ter re­searchers cal­cu­lated that 10% of nonelderly Med­i­caid pa­tient emer­gency depart­ment vis­its were for nonur­gent symp­toms com­pared with 7% for pri­vately in­sured nonelderly pa­tients. Ul­ti­mately, the re­searchers con­cluded, pay­ment re­forms that em­pha­size ac­count­abil­ity for pop­u­la­tion health rather than fee-for-ser­vice may be the in­cen­tive needed to en­cour­age in­vest­ment in al­ter­nate set­tings that pro­vide timely care at less ex­pense than hospi­tal emer­gency de­part­ments.

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