Despite the Affordable Care Act (ACA), according to a report by the Centers for Disease Control and Prevention, ER patient visits have surged in the past few years. Over 28% of doctors polled indicated a significant increase in volume where approximately 47% reports increases.
The ACA goal was to reduce emergency care needs by providing everyone with the basic access to preventative healthcare services. It’s projected that one of the primary reasons ER visits have risen is due to the lack of primary care physicians that accept the newly insured ACA subscribers due to its low reimbursement rates. This results in many patients having nowhere other to go then the emergency room.
Unfortunately having coverage under the ACA doesn’t mean you have access to quality and accessible medical care. Patients put off medical visits due to skyrocketing potential out of pocket costs and wait to the very last minute when their condition becomes an emergency.
Without timely access to primary and specialty care Medicaid subscribers are amongst the highest candidates for ER visits. Medicaid patients wait on average about 2 weeks to see their primary physician and well over a month for a specialist with over half of the providers listed by Medicaid not offering any appointments to enrollees.
Emergency room visits are on track to continue to increase without physicians available to accept Medicaid patients. This is now encumbered by no economic incentive without fines or penalties for patients to go directly to the emergency room for even non-emergency visits. Another driver in ER visits is the vast amount of people that where non-insured until the ACA and prior to the ACA only used the ER for medical care whereas they didn’t then and don’t now have a primary care physician, the ER is their only recourse for care.
Hospitals are working hard to adapt to the new demand on services. Where once the ER was a skeleton crew, today it’s fully staffed around the clock. Are you insured under the ACA but not sure about what your coverage options are in the event of an emergency or general care needs? Access Health has been helping individuals and businesses for over 20 years successfully navigate their medical service needs. Contact Access Health today
MACRA performance based payments