ER visits on the rise

An article in WSJ points out that ER visits are on the rise.  This is the opposite of what was intended by the Affordable Care Act yet it is predictable for several reasons.

1. Primary Care doctors are already busy and already have a difficult time seeing sick patients urgently or on the same day.  They send patients to the ER.  This pattern will get worse because the ACA pays doctors more to do preventative care stuff like check cholesterol levels or order mammograms or do an Annual Exam.  Primary Care doctors will therefore fill their schedules with the preventative care visits and have less time to see sick patients.  The sick people will funnel to the ER more.

2. People with the exchange plans have limited options for a primary care physician.  The networks are small and the “primary care” doctor may not be nearby.  This might change over time, but I don’t think so.  The local ER will be an option.

3. Most of the new insurance plans have a high deductible (which is good) and unless they go here they won’t be to afford to see their doctor so they will go to ER .  Yes, the ER is much more expensive but in reality it is often “free” to the patient because they just don’t pay the bills.  The ERs and hospitals are required to see all-comers no matter what.

Most of the effects of the ACA will be the opposite of what was intended.

One thought on “ER visits on the rise

  1. As a primary care doctor I say you are absolutely right. Just yesterday a patient called me at 7:30 am for fever in her 1 year old. I told her what to do and that I could see him but she should call the office at 8:15 to get an appointment. I couldn’t see her at 8:30 when she walked in (had other pts lined up till 10:30) so she went to the ER. He had a run of the mill fever/cold that in times past would just be handled at home by mom, but now is an ER visit.

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