Emergency department visits increase since ACA implementation

Emergency department (ED) use is up since the beginning of the year, when expanded coverage under the Affordable Care Act (ACA) took effect, according to a new survey from the American College of Emergency Physicians (ACEP).

Nearly half of emergency room doctors report an increase in visits since January 1, according to the survey, while 86 percent expect visits to increase in the next three years. Three-quarters of the physicians don't think their EDs are prepared for the expected increase in visits.

"Emergency visits will increase in large part because more people will have health insurance and therefore will be seeking medical care," ACEP President Alex Rosenau said in a statement. "But America has severe primary care physician shortages, and many physicians do not accept Medicaid patients, because Medicaid pays so low.  When people can't get appointments with physicians, they will seek care in emergency departments. In addition, the population is aging, and older people are more likely to have chronic medical conditions that require emergency care."

A large majority--84 percent--say their EDs "board" psychiatric patients, a major cause of ED overcrowding. More than half of the respondents say they now spend more time and energy transferring psychiatric patients.

Lasting solutions to the influx of ED patients, such as increasing the number of primary care physicians in the workforce, will take years to work, Rosenau said. For immediate relief, he called on Congress and President Barack Obama to take action to strengthen EDs.

"ACEP is urging Congress to make a firm commitment to emergency patients by holding a hearing to examine whether additional strains are occurring in the emergency department safety net as a consequence of the Affordable Care Act," he said in the statement.

A March study found that since Massachusetts' 2006 healthcare reform law, ED use in the Bay State similarly increased, FierceHealthcare previously reported.

To learn more:
- read the survey results (.pdf)
- here's the statement