Medicaid beneficiaries report higher ED use, more barriers to care

Study: About 40% of Medicaid patients visited an ED in the last year

Topics: Emergency Department, Service Lines, Medicaid, Reimbursement, Finance, Access to Care, Quality, Performance Improvement, Primary Care

March 20, 2012

Medicaid beneficiaries are nearly twice as likely to face barriers to primary health care and visit hospital EDs as privately insured individuals, according to a study in the Annals of Emergency Medicine.

For the study, researchers at the University of Colorado School of Medicine analyzed the responses of 230,258 patients who participated in the National Health Interview Surveys from 1999 to 2009.

The study considered five barriers to primary care, including not being able to reach a physician by phone, not being able to obtain a timely appointment, facing a long wait in a physician's office, lacking transportation, and confronting limited clinic hours.

  • Learn what Health Care Advisory Board experts are saying about one innovative approach to Medicaid primary care shortfalls: the Medicaid Health Home.

They found that 16.3% of Medicaid beneficiaries reported facing at least one barrier to primary care, compared with 8.9% of privately insured individuals. In addition, the study showed that 40% of Medicaid beneficiaries visited an ED within the last 12 months, compared with 17.7% of individuals with private insurance.

Commenting on the findings, David Seaberg, president of the American College of Emergency Physicians, noted that "efforts by some states to keep Medicaid patients out of the ED do not take this lack of access to primary care into account."

Seaberg added, "It puts both patients and providers into an impossible position that will only get worse as more people enroll in Medicaid." Approximately 16 million individuals are expected to enroll in Medicaid across the next 10 years, researchers said (UPI, 3/18; Smith, MedPage Today, 3/16).

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