ER visits: Reducing inappropriate use proves an uphill struggle

Reducing emergency department use is one of the Affordable Care Act's primary goals, but the law has barely moved the needle, according to a new report from the Centers for Disease Control and Prevention (CDC).

Based on data from the 2013 and 2014 National Health Interview Survey, nearly one in five adults visited the ED at least once a year. Twelve percent said they did so because their primary care practice wasn't open and seven percent said emergency care was the only provider to which they had access. 

Expanding primary care access to reduce such inappropriate ED use is a major goal among healthcare providers, but research suggests external factors, such as local government cutbacks to behavioral treatment access, may keep patients coming back for non-emergency services.

The CDC analyzed changes in ED use rates between 2013, when nearly 8 million people gained insurance coverage through the ACA, and 2014. Overall use changed very little during this period, but the percentage of patients visiting twice or more in a year saw a small decline from 8 percent to 6 percent.

The research found a more noticeable decline in ED visits among Medicaid patients and the uninsured population. However, a significantly higher proportion of Medicaid patients (35 percent) visited the ED compared to privately insured (14.5 percent) and uninsured patients (16.5 percent). Medicaid patients were more likely than privately insured or uninsured patients to cite seriousness of their condition as their reason for visiting the ED.

To learn more:
- read the report (.pdf)