Thursday, June 12, 2014

And About Those Emergency Room Visits Supposedly Declining Under ACA. Maybe Not So Much. How About An Increase in ER Visits! Yes, Very Much.

“It wasn't supposed to work this way, but since the Affordable Care Act took effect in January, 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 — is spurring the hospital to convert a waiting room into more exam rooms.

"We're seeing patients who probably should be seen at our (immediate-care centers)," said Lewis Perkins, the hospital's vice president of patient care and chief nursing officer. "And we're seeing this across the system."

That's just the opposite of what many people expected under Obamacare, particularly because one of the goals of health reform was to reduce pressure on emergency rooms by expanding Medicaid and giving poor people better access to primary care.

Instead, 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, and nearly nine in 10 expect those visits to rise in the next three years. Mike Rust, president of the Kentucky Hospital Association, said members statewide describe the same trend.”

"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.

"It's a perfect storm here," said Dr. Ryan Stanton of Lexington, president of the Kentucky chapter of the ER physician group."We've given people an ATM card in a town with no ATMs." '

"For many who research health care, the ER crunch is no surprise.

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." - More patients flocking to ERs under Obamacare,, 06/09/2014

Upon further review, the “experts” are claiming the ER is being used due to the lack of primary care physicians accepting Medicaid. Yet Medicaid recipients, according to Kaiser Family Foundation,
in 2007, found Medicaid patients made up an inordinate amount of total ER visits. The Kaiser 2007 finding would be prior to ACA/Obamacare.

If the trend/pattern of group M is to inordinately rely on facility E, and one purposely increase the size of group M, then one would assume, given the established trend and pattern, the increased size of group M would increase the inordinate reliance on facility E. One might state: As M rises E rises, given trend/pattern.

Which then begs the question of: What ACA “experts” predicted a decline in ER usage due to the advent of ACA/Obamacare and its major subcomponent which is the expansion of Medicaid? Apparently it is another episode for Math Quest!

Link to the courier-journal article appears below:

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