Emergency room visits continue to rise despite the implementation of the Affordable Care Act (ACA) according to a new report from the Centers for Disease Control (CDC). The National Center for Health Statistics conducted an interview survey to find out why adults ages 18-64 visit the emergency room. The main reasons include seriousness of medical problems exhibited by the patient, and lack of access to other medical providers. The report found that there were “few changes in emergency room (ER) use” in 2013 and 2014.
The key findings for the rise in ER use during this time period include:
- Seriousness of the medical problem was a key reason that patients visited the ER, especially among those adults with Medicaid coverage vs. private insurance coverage.
- Patient’s inability to see their own doctor during office operating hours.
- Patients living in nonmetropolitan areas were twice as likely to visit the emergency room.
- Those without insurance and access to medical providers were twice as likely to visit the emergency room.
These findings are similar to a poll conducted by the American College of Emergency Physicians (http//www.acep.org/) in 2015, where three-quarters of emergency physicians reported that emergency visits were increasing. About 90 percent of the 2000 emergency physicians polled said that the severity of illness or injury among emergency patients had either increased (44%) or remained the same (42%). More than half of the emergency physicians polled said the number of Medicaid patients visiting the emergency room is increasing.
Another study with similar results was issued by Health Policy Alternatives. This study found that policymaker and health insurance plan efforts to incentivize Medicaid patients to use primary care providers rather than the ER were ineffective. More than half of providers listed by Medicaid Managed Care plans were unable to give appointments to enrollees, despite a provision in the ACA boosting pay to primary care physicians who treat Medicaid patients. The median wait time to visit a primary care provider was 2 weeks, but over one-quarter of Medicaid patients had to wait up to a month to see a provider.
“America has severe primary care physician shortages, and many physicians will not accept Medicaid patients because Medicaid pays so inadequately,” said Michael Gerardi, MD, FAAP, FACEP, president of ACEP. “The reliance on emergency care remains stronger than ever,” Dr. Gerardi said.
Source: CDC National Health Statistics Report, “Reasons for Emergency Room Use Among US Adults Aged 18-64: National Health Interview Survey, 2013 and 2014”
Source: 2015 ACEP ACA Poll Report
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