Medicaid Patients Not Overusing Emergency Departments

Medicaid enrollees visit the emergency department appropriately like most patients, but they have generally more complex health needs and less access to primary care than their privately insured counterparts.


Medicaid enrollees visit the emergency department appropriately like most patients, but they have generally more complex health needs and less access to primary care than their privately insured counterparts.

That is the finding of a new report from the Medicaid and CHIP Payment and Access Commission (MACPAC), according to the American College of Emergency Physicians (ACEP).

"This report from MACPAC confirms that Medicaid patients, like all emergency patients, depend on the emergency department to diagnose and treat what is wrong with them or to reassure them that what they feared could be very dangerous is not," said ACEP President Alex Rosenau, D.O.

"MACPAC found that non-urgent visits accounted for just 10 percent of Medicaid visits to the ER, which is very close to that of the general population: about 8 percent," said Rosenau. "A report from the Centers for Studying Health System Change in 2012 also found that most emergency visits by Medicaid patients are for urgent or serious symptoms. In short, the mounting research shows that most of these patients have serious and complex medical problems that can only be addressed in the emergency department."

Rosenau also said the lack of access to primary care certainly contributes to Medicaid patients' use of the ER, but for Medicaid patients with serious mental illness, multiple illnesses, and homelessness, even having a primary care physician is no bar against appropriate emergency department use.

"In general, the combination of poverty and illness present challenges with few genuinely simple solutions, despite misplaced beliefs that significant healthcare costs could be saved by keeping patients out of the ER," he said.

The full MACPAC report is available here.

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