Hospitals Admit: Medicaid Expansion Increased ED Use
The evidence that Medicaid expansion increases use of hospitals’ emergency departments is coming fast and thick. Hospital executives are longer afraid to admit it, and have given up the pretense that Medicaid increases timely, quality, primary care. Here’s one form Fort Smith, Arkansas:
Almost a year after the first health insurance enrollment under the Affordable Care Act, local hospitals Sparks Regional Medical Center and Mercy Fort Smith have seen an uptick in emergency room visits. Shelly Cordum, nursing chief executive for Sparks Regional Medical Center in Fort Smith, says the Sparks emergency department saw 6,700 patients in July. The trend is not expected to decline either. “The Medicaid expansion and the health care option certainly has spurred this influx, without a doubt,” Cordum said. “It’s people from all walks of life. They’re coming in with all different kinds of medical problems, and they enter the hospital through the ER because many don’t have a primary care physician and they are very sick.” (Fort Smith Times Record)
“They’re coming in with all different kinds of medical problems, and they enter the hospital through the ER because many don’t have a primary care physician and they are very sick.”
Yep, that’s because there aren’t enough primary care docs taking Medicaid patients.
Many states set reimbursements so low that primary care doctors aren’t enthusiastic about accepting new Medicaid enrollees into their practices. Plus, many Medicaid enrollees may not have made arrangements for a usual source of care. There is also the problem that they perceive the cost of a (non-emergent) ER visit as free. Unless people have an incentive to avoid the ER, they will use it like a primary care provider.
“Many states set reimbursements so low that primary care doctors aren’t enthusiastic about accepting new Medicaid enrollees into their practices.”
Do you believe that the reimbursements be set higher without raising premiums ?
Not within the current system. However, a medical-insurance plan with no access to doctors makes no sense at all.