Medicaid patients with PCP barriers flock to ED--more coming soon

Medicaid patients face more nonfinancial barriers to timely primary care than those with private insurance, which in turn make them more likely to visit the emergency department, according to a study in Annals of Emergency Medicine.

The study found more than 16 percent of Medicare patients reported one or more barriers to primary care, compared to 8.9 of those privately insured. Moreover, Medicaid patients were more than twice as likely to use the ED (39.6 percent) than privately insured patients (17.7 percent).

When taking into account barriers to primary care, Medicaid patients still had higher ED utilization (51.3 percent versus 24.6 percent for one barrier and 61.2 percent versus 28.9 percent for two barriers).

Barriers included not being able to get an appointment soon enough, having to wait too long in the physician's office and no transportation, among other challenges, according to the study.

Noting that Medicaid patients who have primary care physicians still reported significant barriers to seeing their doctor, researchers warned that expanding Medicaid coverage to more low-income patients may boost ED visits--unless nonfinancial barriers to primary care are eliminated.

"Our findings are particularly worrisome in light of the additional 16 million people who will be added to the Medicaid rolls over the next decade," senior author Adit Ginde of the University of Colorado School of Medicine said in a statement.

Meanwhile, to help curb the "overuse and abuse" of costly emergency care, Washington hospitals will no longer receive Medicaid reimbursement for any "unnecessary" emergency room visits starting next month.

For more information:
- here's the press release
- check out the study (.pdf)