Trips to the ER Aren't Declining

Dennis Domrzalski, Reporter- Albuquerque Business First

One of the theories behind the Affordable Care Act was that with most every American getting health insurance, visits to hospital emergency rooms would decline as more people got preventive care from primary care doctors.

But a survey from the American College of Emergency Physicians shows the opposite is happening.

Nearly half of all emergency doctors surveyed said they have seen an increase in the number of patients using emergency rooms since Jan. 1, which is when the ACA took full effect. Nine percent said volume had increased greatly, and 37 percent said it had increased slightly. Forty-seven percent said volume was the same or decreased slightly.

Forty-one percent of the doctors said they expected emergency room visits to increase greatly over the next three years, and 45 percent said they expect slight increases in visits.

At Presbyterian Hospital in Downtown Albuquerque, ER visits are up 6.6 percent for the first four months of the year compared to 2013, said Dr. Darren Shafer, Presbyterian’s director of Emergency Medicine. And, ER visits for the first four months of 2013, were up five percent from 2012.

Presbyterian Health Plan President Lisa Lujan said some of this year’s increase could be due to ACA plans.

“When we compare members with ACA-compliant Presbyterian Health Plan products and PHP members who have legacy individual plans, we are seeing higher Emergency Department use rates in the members enrolling under ACA plans, which is consistent with national trends,” Lujan said.

At Lovelace Health System, which operates five hospitals in the Albuquerque area, emergency room visits are up 1 percent so far this year, a company spokeswoman said.

“Emergency visits will increase in large part because more people will have health insurance and therefore will be seeking medical care,” said ACEP President Alex Rosenau. “But America has severe primary care physician shortages, and many physicians do not accept Medicaid patients, because Medicaid pays so low.”

“When people can’t get appointments with physicians, they will seek care in emergency departments. In addition, the population is aging, and older people are more likely to have chronic medical conditions that require emergency care,” he added.

The survey added that states like New Mexico that have expanded Medicaid coverage are likely to see increases in the volume of Medicaid emergency room patients.

Since October, New Mexico’s Medicaid rolls have grown by 112,000, according to the New Mexico Human Services Department. There are now about 612,000 New Mexicans on Medicaid.

Albuquerque Business First

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