More patients flocking to ERs under Obamacare

Article by Laura Ungar of the Courier-Journal. Excerpts: 

 "Norton Hospital has seen its packed emergency room become even more crowded, with about 100 more patients a month.

That 12 percent spike in the number of patients — many of whom aren't actually facing true emergencies"

"That's just the opposite of what many people expected under Obamacare,"

"many hospitals in Kentucky and across the nation are seeing a surge of those newly insured Medicaid patients walking into emergency rooms."

"Nationally, nearly half of ER doctors responding to a recent poll by the American College of Emergency Physicians said they've seen more visits since Jan. 1"

"Experts cite many reasons: A longstanding shortage of primary-care doctors leaves too few to handle all the newly insured patients. Some doctors won't accept Medicaid. And poor people often can't take time from work when most primary care offices are open, while ERs operate round-the-clock and by law must at least stabilize patients.

Plus, some patients who have been uninsured for years don't have regular doctors and are accustomed to using ERs, even though it is much more expensive. Others have let illnesses and injuries fester so long they have become emergencies."

"A report from the Robert Wood Johnson Foundation said the average ER visit costs $580 more than a trip to the doctor's office."

"Studies have shown that Medicaid patients were among the most frequent ER users before health reform, and becoming newly insured only increases ER use by giving an avenue to get treatment to patients who had been forgoing care because they couldn't afford it."

"A 2007 issue brief from the Kaiser Family Foundation said Medicaid patients made up 9 percent of the general population at the time but accounted for 15 percent of emergency visits. Researchers concluded that the most frequent users weren't substituting ERs for primary care, but rather suffered from chronic conditions and required more health care in general."

"getting covered under Oregon's 2008 expansion of a Medicaid program for uninsured adults increased ER use by 0.41 visits per person, or 40 percent relative to visits among a control group."

"Claims data from Passport Health Plan, a Louisville-based Medicaid managed-care organization, separates out the newly insured, and suggests they are slightly more likely to use emergency rooms than traditional Medicaid patients."

"A workforce capacity study conducted for the state by Deloitte Consulting last year found that Kentucky needed 3,790 more doctors, including 183 more primary-care physicians, to meet pre-ACA demand. Under the law, it said the state may need to add an additional 284 primary-care physicians by 2017. Complicating matters, a quarter of Kentucky's primary-care doctors could be ready to retire within five years, the report said."

"While primary care may be difficult to find, emergency rooms cannot turn anyone away."

"Mason said letting nurse practitioners practice and prescribe on their own also may help by giving people another treatment alternative."
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