Dive Brief:
- According to data from a 10-year study by Johns Hopkins researchers, charging co-payments for emergency department visits by Medicaid patients with non-urgent medical needs doesn't do anything to reduce the practice. The study was published this week in JAMA Internal Medicine.
- The study compared the use of EDs between the years of 2001 and 2010 in eight states where hospitals were allowed to charge co-pays, with ED use in 10 states where hospitals were not allowed to charge ED co-pays.
- The failure of cost-sharing in the ED to impact usage has implications for how cost-sharing should be approached in Medicaid moving forward, says lead study author Mona Siddiqui, MD, MPH, assistant professor of internal medicine at the Johns Hopkins University School of Medicine.
Dive Insight:
These ED co-pays, which were authorized by Congress in 2005 in an attempt to steer Medicaid patients out of EDs and toward primary care physicians, are not doing their job. The real question is why. The study authors suggest that contributing factors in Medicaid patients' continued, non-urgent use of EDs could include lack of access to primary care physicians, and gray area among patients and hospitals in deeming what is "non-urgent."
These findings add weight to the issue of access to primary care. "The shortage that we know exists of primary care providers in a lot of rural areas and in Medicaid-heavy populations plays a huge role in patients then not being able to seek care with a longitudinal provider," Siddiqui was quoted by HealthLeaders Media.
Want to read more? You may enjoy this story on a simple method for reducing ED visits.