Will Healthcare Reform Have an Unintended Consequence on ED Use?

Newly insured may place additional strain on already overburdened Emergency Departments.  Healthcare reform could prove to be a mixed blessing for some hospitals because the law has the potential to negatively impact their bottom lines. According to a report entitled Will Healthcare Reform Alter the Landscape of the Emergency Department? conducted by IMA Consulting, the law may have an unintended consequence in that the newly insured might take advantage of both the Emergency Department (ED) and their sudden access to primary-care physicians.  “One of the pieces of research that we looked at was that people who tend to have insurance – particularly Medicare and Medicaid – access the ED more than people who are uninsured,” according to Bob Gift, IMA Consulting Director.  “This is possibly because they’re not necessarily stuck paying the entire bill.”

According to Gift, people who currently lack insurance tend to avoid the healthcare system, unless they use the ED.  “New patients may think, I have insurance so ‘what the heck; I may as well go to the ED,'” he said.  Because EDs are already operating at or above capacity and there’s a shortage of primary-care physicians, Gift believes that — if the law works correctly — patients are likely to use their new insurance coverage to access doctors and get care for health problems sooner rather than later.  In a perfect world, this would cut the number of ED visits and reduce inpatient admissions.  Time will tell whether health insurance encourages ED or primary-care physician visits.

“By opening enrollment to larger numbers of participants who heretofore didn’t have coverage, we may find that patients are accessing the system more freely than when they paid out of pocket – that’s what a number of folks who are looking at this tend to anticipate happening,” Gift said.

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