Medicaid expansion delivers ED care more quickly, study says
Researchers determined that Medicaid expansion provides patients with greater choice in hospitals and reduced average travel time to emergency departments, according to a study published Tuesday by Annals of Internal Medicine.
Hospitals in states that expanded Medicaid say a 47.1% drop in uninsured ED visits in the 12 months following expansion and Medicaid visits increased 125.7%.
These results show benefits to Medicaid expansion, although expansion has also produced some unanticipated and unintended effects, as well.
Researchers looked at data covering more than one million ED visits at for-profits by adult patients in 2013 and 2014. They focused non-discretionary conditions that almost always require ED care regardless of insurance coverage. The results could translate into improved outcomes for patients.
Insurance coverage achieved through Medicaid expansion allow patients to receive care from a broader range of hospitals, which could mean a closer hospital. There was a 6.2% decrease in average travel time to ED departments in states that expanded Medicaid, which might improve outcomes. “Minutes cut down traveling to the hospital can literally make the difference for whether a patient lives or dies,” Brendan Saloner, a researcher at John Hopkins University who is unassociated with this study, told Reuters.
There is some doubt that the results could lead to improved outcomes. The study didn’t investigate how long patients wait to receive care once they arrive at a hospital, according to Reuters. Additionally, benefits could be limited to patients in urban areas. Patients in other areas might not have closer options available.
Medicaid expansion has delivered mixed results so far. Policymakers had hoped expansion would lead to more reliance on primary care services rather the ED services, but this doesn’t appear to have occurred, as the Washington Post reported in October. Hospitals are probably not too unhappy. A study published by Health Affairs in August showed that uncompensated care costs have fallen in states that expanded Medicaid.
- Annals of Internal Medicine Insurance Expansion and Hospital Emergency Department Access: Evidence From the Affordable Care Act