Comparison of Emergency Room Utilization for Non-Emergent Purposes Before and After the Implementation of the Affordable Care Act

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Abstract

The implementation of the Patient Protection and Affordable Care Act (ACA) brought significant changes to the healthcare landscape. Many of the provisions of the ACA were intended to create greater access to healthcare services as well as to lower overall healthcare costs. One of the intentions of the ACA was to provide opportunities for patients to seek treatment at the appropriate level of care, i.e. primary care outpatient visits rather than emergency room (ER) utilization. The premise of this effort ostensibly was to lower healthcare costs by treating non-emergent illnesses at the lowest cost level. Additional provisions of the ACA such as mandated insurance coverage were intended to provide insurance coverage for patients to seek primary care services. Thus the cumulative impact of these provisions was predicted to increase access to primary care while simultaneously reducing non-emergent utilization of ER services. This study documents overall ER utilization as well as ER visits for non-emergent treatment before and after the implementation of the ACA. The analysis of the data revealed ER utilization increased in the five years after the ACA went into effect compared to the five-year period before the Act was implemented. In addition to the overall increase in ER visits, non-emergent visits also increased significantly during the same evaluation period. The study also revealed that Medicaid was the most common payer source for ER visits and unnecessary ER utilization rates were higher for rural hospitals than urban hospitals.
Original languageAmerican English
JournalOklahoma State Medical Proceedings
Volume1
Issue number2
StatePublished - 2018

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Patient Protection and Affordable Care Act
Hospital Emergency Service
Primary Health Care
Insurance Coverage
Health Care Costs
Delivery of Health Care
Rural Hospitals
Urban Hospitals
Medicaid
Outpatients
Costs and Cost Analysis

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title = "Comparison of Emergency Room Utilization for Non-Emergent Purposes Before and After the Implementation of the Affordable Care Act",
abstract = "The implementation of the Patient Protection and Affordable Care Act (ACA) brought significant changes to the healthcare landscape. Many of the provisions of the ACA were intended to create greater access to healthcare services as well as to lower overall healthcare costs. One of the intentions of the ACA was to provide opportunities for patients to seek treatment at the appropriate level of care, i.e. primary care outpatient visits rather than emergency room (ER) utilization. The premise of this effort ostensibly was to lower healthcare costs by treating non-emergent illnesses at the lowest cost level. Additional provisions of the ACA such as mandated insurance coverage were intended to provide insurance coverage for patients to seek primary care services. Thus the cumulative impact of these provisions was predicted to increase access to primary care while simultaneously reducing non-emergent utilization of ER services. This study documents overall ER utilization as well as ER visits for non-emergent treatment before and after the implementation of the ACA. The analysis of the data revealed ER utilization increased in the five years after the ACA went into effect compared to the five-year period before the Act was implemented. In addition to the overall increase in ER visits, non-emergent visits also increased significantly during the same evaluation period. The study also revealed that Medicaid was the most common payer source for ER visits and unnecessary ER utilization rates were higher for rural hospitals than urban hospitals.",
author = "James Hess and Barbara Miller and William Paiva and Jeffrey Stroup",
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language = "American English",
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journal = "Oklahoma State Medical Proceedings",
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T1 - Comparison of Emergency Room Utilization for Non-Emergent Purposes Before and After the Implementation of the Affordable Care Act

AU - Hess, James

AU - Miller, Barbara

AU - Paiva, William

AU - Stroup, Jeffrey

PY - 2018

Y1 - 2018

N2 - The implementation of the Patient Protection and Affordable Care Act (ACA) brought significant changes to the healthcare landscape. Many of the provisions of the ACA were intended to create greater access to healthcare services as well as to lower overall healthcare costs. One of the intentions of the ACA was to provide opportunities for patients to seek treatment at the appropriate level of care, i.e. primary care outpatient visits rather than emergency room (ER) utilization. The premise of this effort ostensibly was to lower healthcare costs by treating non-emergent illnesses at the lowest cost level. Additional provisions of the ACA such as mandated insurance coverage were intended to provide insurance coverage for patients to seek primary care services. Thus the cumulative impact of these provisions was predicted to increase access to primary care while simultaneously reducing non-emergent utilization of ER services. This study documents overall ER utilization as well as ER visits for non-emergent treatment before and after the implementation of the ACA. The analysis of the data revealed ER utilization increased in the five years after the ACA went into effect compared to the five-year period before the Act was implemented. In addition to the overall increase in ER visits, non-emergent visits also increased significantly during the same evaluation period. The study also revealed that Medicaid was the most common payer source for ER visits and unnecessary ER utilization rates were higher for rural hospitals than urban hospitals.

AB - The implementation of the Patient Protection and Affordable Care Act (ACA) brought significant changes to the healthcare landscape. Many of the provisions of the ACA were intended to create greater access to healthcare services as well as to lower overall healthcare costs. One of the intentions of the ACA was to provide opportunities for patients to seek treatment at the appropriate level of care, i.e. primary care outpatient visits rather than emergency room (ER) utilization. The premise of this effort ostensibly was to lower healthcare costs by treating non-emergent illnesses at the lowest cost level. Additional provisions of the ACA such as mandated insurance coverage were intended to provide insurance coverage for patients to seek primary care services. Thus the cumulative impact of these provisions was predicted to increase access to primary care while simultaneously reducing non-emergent utilization of ER services. This study documents overall ER utilization as well as ER visits for non-emergent treatment before and after the implementation of the ACA. The analysis of the data revealed ER utilization increased in the five years after the ACA went into effect compared to the five-year period before the Act was implemented. In addition to the overall increase in ER visits, non-emergent visits also increased significantly during the same evaluation period. The study also revealed that Medicaid was the most common payer source for ER visits and unnecessary ER utilization rates were higher for rural hospitals than urban hospitals.

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JO - Oklahoma State Medical Proceedings

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