Medicaid patients’ use of ER may be exaggerated: report
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.