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Message
ER visits increase under Obamacare
Posted on 9/9/14 at 6:11 pm
Posted on 9/9/14 at 6:11 pm
quote:
The analysis by the Colorado Hospital Association found that the average number of ER visits in states that expanded Medicaid increased by 5.6 percent, when the second quarter of this year was compared with the same period in 2013.
The increase was more than three times larger than experienced by hospitals in states that did not expand.
The jump was also outside the range of normal year-to-year fluctuations.
“When this newly insured population is trying to understand the system, they are using the easiest access point, and that is the ER,” said Chris Tholen, a vice president of the hospital association.
The study looked at data reported by 450 hospitals in 25 states, through the middle of this year. Thirteen of the states expanded Medicaid and 12 states did not.
LINK
When statists on this board continually claimed that ER visits would decrease under the ACA, prudent folks pointed out that without an increase in the supply of doctors, ER visits would be the only option for these newly insured.
11
Posted on 9/9/14 at 6:22 pm to HailHailtoMichigan!
You cannot ignore scarcity.
Posted on 9/9/14 at 6:30 pm to HailHailtoMichigan!
quote:
When statists on this board continually claimed that ER visits would decrease under the ACA...
ER visits will increase under a system where it makes such visits more affordable. Anybody that doesn't understand this needs help.
Posted on 9/9/14 at 6:31 pm to HailHailtoMichigan!
All reasonable people saw this coming, and also saw that mandatory expanded preventative care benefits would do next to nothing to offset the cost of it.
Posted on 9/9/14 at 6:32 pm to HailHailtoMichigan!
quote:The rise in ER visits by Medicaid patients roughly equals a decline in underinsured and charity care ER vists.
When statists on this board continually claimed that ER visits would decrease under the ACA, prudent folks pointed out that without an increase in the supply of doctors, ER visits would be the only option for these newly insured.
Posted on 9/9/14 at 6:35 pm to HailHailtoMichigan!
What is the ideal number of ER visits? 
This post was edited on 9/9/14 at 6:37 pm
Posted on 9/9/14 at 6:37 pm to mmcgrath
quote:So in that scenario, the loser is the taxpayer; the winner is the hospital. Right?
The rise in ER visits by Medicaid patients roughly equals a decline in underinsured and charity care ER vists.
Posted on 9/9/14 at 6:37 pm to mmcgrath
quote:
The rise in ER visits by Medicaid patients roughly equals a decline in underinsured and charity care ER vists.
Is that true?
Posted on 9/9/14 at 6:41 pm to Scruffy
quote:
Is that true?
It has to be. It's posted on an internet message board.
Posted on 9/9/14 at 6:41 pm to Scruffy
quote:Depends on what the meaning of ""roughly" is.quote:Is that true?
The rise in ER visits by Medicaid patients roughly equals a decline in underinsured and charity care ER vists.
Posted on 9/9/14 at 6:43 pm to HailHailtoMichigan!
The over-utilization of the ER was never by the uninsured. It was by the government-insured. Now more are government-insured and presto! More ER visits.
Science.
Science.
Posted on 9/9/14 at 6:46 pm to 90proofprofessional
quote:
All reasonable people saw this coming, and also saw that mandatory expanded preventative care benefits would do next to nothing to offset the cost of it.
That's because, contrary to what passes for conventional wisdom these days, preventive care is damn expensive.
Posted on 9/9/14 at 7:31 pm to the808bass
Not that surprising. Romneycare had exactly the same result.
Posted on 9/9/14 at 7:37 pm to Bestbank Tiger
Oregon the same post 08 expansion.
Posted on 9/9/14 at 7:38 pm to Iosh
quote:
What is the ideal number of ER visits?
0 for nonemergencies
Posted on 9/9/14 at 7:42 pm to HailHailtoMichigan!
We obviously need more government to fix the problem that government created.
Posted on 9/9/14 at 8:10 pm to Scruffy
quote:Colorado Hospital Association Report It is listed on the report given by the Colorado Hospital Association, which is what the OP's article is based on.
Is that true?
quote:
The increase in Medicaid volume (29 percent), which occurred only in expansion states, is demonstrably due to Medicaid expansion. However, the parallel decrease in self-pay (25 percent) and charity care (30 percent) shows that previously uninsured patients are the individuals newly enrolled in Medicaid.
quote:
“While media reports have detailed increases in Medicaid volume in hospitals located in expansion states, we now have definitive proof that such increases are translating into reduced self-pay and charity care cases,” said Steven J. Summer, president and CEO of CHA. “These findings not only affirm that more people are finding health care coverage who didn’t have it before, but also that it is having a positive impact by reducing the levels of uncompensated care at hospitals, which could further efforts to reduce health care costs.”
Not that the change was entirely unexpected... and I don't know exactly how the percentages of cases match up in total numbers. They believe that there is a small "woodwork effect" that may be a general national trend as people who were eligible but not enrolled are now enrolling in Medicaid. Maybe because the whole Obamacare web site launch led them to discover it was an option?
Still only two quarters worth of data. The trend into next year and more national reports would be telling. Even though it is favorable, I won't trust any single source 100%.
Posted on 9/9/14 at 8:20 pm to 90proofprofessional
quote:
All reasonable people saw this coming, and also saw that mandatory expanded preventative care benefits would do next to nothing to offset the cost of it.
Exactly.
Posted on 9/9/14 at 8:40 pm to mmcgrath
quote:
The increase in Medicaid volume (29 percent), which occurred only in expansion states, is demonstrably due to Medicaid expansion. However, the parallel decrease in self-pay (25 percent) and charity care (30 percent) shows that previously uninsured patients are the individuals newly enrolled in Medicaid.
That definitely mitigates the problem, if your preference is a reduction in self-pay and an increase in Medicaid outlays (it isn't mine).
BUUUUUUUUT, the similarity in percentage-changes is almost certainly a very bad choice for a metric upon which to base such a comparison.
That's because unless Total Medicaid Volume = Total Self-pay Volume + Total Charity Volume, a comparison of %-changes doesn't really tell us anything about how much actual money we're saving or losing.
Not saying that the volumes aren't roughly equal in objective $-terms, but that CHA link (even the full report) doesn't provide the total volume changes in that way- it only shows percentage changes and average $-changes per hospital in a few cases.
Meanwhile the reader has no idea of the relative total size of each type of payer. That reeks of sleight-of-hand, fwiw.
Posted on 9/9/14 at 8:45 pm to 90proofprofessional
quote:I'll agree with all of that. I am a numbers person. I think one of their reports even indicate that the newer cases are more complex due to the fact that serious problems may have previously been ignored. In the end what we are really looking for is how the trends will level off and if the added insured will reduce medical costs enough to offset the added costs.
That definitely mitigates the problem, if your preference is a reduction in self-pay and an increase in Medicaid outlays (it isn't mine).
BUUUUUUUUT, the similarity in percentage-changes is almost certainly a very bad choice for a metric upon which to base such a comparison.
That's because unless Total Medicaid Volume = Total Self-pay Volume + Total Charity Volume, a comparison of %-changes doesn't really tell us anything about how much actual money we're saving or losing.
Not saying that the volumes aren't roughly equal in objective $-terms, but that CHA link (even the full report) doesn't provide the total volume changes in that way- it only shows percentage changes and average $-changes per hospital in a few cases.
Meanwhile the reader has no idea of the relative total size of each type of payer. That reeks of sleight-of-hand, fwiw.
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