Illinois emergency room use spikes after ACA

Photo credit: Getty/Nils Versemann

Reducing the use of emergency rooms for routine care is a major goal of the Affordable Care Act, but ER use is up in Illinois since the law’s implementation, according to a new study.

Researchers found emergency visits in Illinois spiked by more than 14,000 visits per month in 2014 and 2015, an increase of nearly 6 percent when compared with 2011 and 2013, according to the study (.pdf) published in the Annals of Emergency Medicine. The research team, led by Scott Dresden of Northwestern University Feinberg School of Medicine, uncovered that ER visits from uninsured patients are down, but not by enough to offset the increase in visits from the privately insured and Medicaid recipients.

This echoes a similar increase within the nation at large, FierceHealthcare previously reported, with a February report from the Centers for Disease Control and Prevention finding the ACA has done little to stem the use of emergency care for primary care.

It’s difficult to predict whether the surge will last; researchers noted it may simply be a temporary spike due to newly-insured patients finally addressing long-untreated conditions. Jay Bhatt, chief health officer for the Illinois Health and Hospital Association and a practicing physician in Chicago, told the Chicago Tribune he subscribes to this theory, telling the newspaper that a number of patients are learning to use health insurance for the first time. 

"I think there's just going to be a lot more education," he said. "The learning curve on how to use coverage doesn't happen overnight."

Another possibility also relates to lack of education for the newly insured, according to the study: many patients with no experience with coverage may be unaware they have timely, effective care options outside of the emergency department.

Despite the statewide numbers, individual providers have had success reducing unnecessary ER use, according to the Tribune. For example, at Advocate Physician Partners, Advocate Health Care’s aligned physician network, care managers get in touch with patients if they feel their ER use could be better served with a primary care provider.