Newly insured may still choose ERs over physician visits

Although hundreds of thousands previously uninsured consumers now have Medicaid coverage, it could take a long time before they feel comfortable enough to seek treatment from a doctor rather than the emergency room, according to the Chicago Tribune.

Many new patients now covered under Medicaid through expansion of the program under the Affordable Care Act are unfamiliar with a normal doctor-patient relationship. As a result, they might stick with what they know--trips to the emergency room, experts told the Tribune

Lack of healthcare literacy, along with no previous interactions with primary care physicians, could hinder the newly insured and revert them back to old habits, said Elbert Huang, M.D.

"There's this huge deficit of knowledge about how to use the healthcare system that still needs to be overcome before people can benefit from having health insurance. It's like you've given people a license to drive, but they don't have a map," Huang, an associate professor of medicine at the University of Chicago and a former senior adviser for planning and evaluation in the U.S. Department of Health and Human Services, said in the article.

Another issue is access to doctors. Illinois officials expect to see a jump from 2.7 million to 3 million Medicaid recipients over the next few years, a bump providers said the system can handle. But physician shortages might cause a problem, pushing people waiting to see a doctor back into the emergency rooms, the Tribune reported. "For Medicaid patients, the issue is who's going to accept them, and where," Huang said. "Doctors often practice on the Gold Coast or in well-off suburbs, not in the poorest areas." 

However, 17,000 doctors in Illinois accept Medicaid patients and about 75 percent of physicians across the country accept patients on public insurance such as Medicaid, according to the article.

An increase in insured hospital patients due to Medicaid expansion led to a 40 percent rise in their visits to the emergency room, according to a study published in Science, FierceHealthcare previously reported. Furthermore, based on a Medicaid lottery program in Oregon, enrollment in Medicaid increased the likelihood of emergency department use by 7 percent.

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