- Emergency department (ED) visit rates have grown more slowly in states that implemented Medicaid expansion than in other states, according to a new Deloitte report.
- New Medicaid enrollees reported fewer issues accessing certain healthcare settings, such as primary care, than uninsured patients.
- Urgent care centers seem to be associated with lower ED visit rates in areas where they are located.
The ED is a costly place to receive care. ED visit rates were one factor the Affordable Care Act (ACA) considered as a barometer to track healthcare quality. The Deloitte report indicates the ACA is doing well, at least when it comes to ED visit rates.
ED visits are far more expensive than hospital outpatient visits or primary care physician visits, according to Deloitte. The average ED visit cost $999 in 2013 compared to $885 on average for outpatient hospital visits or $200 for primary care physician visits, according to the report.
Since Medicaid expansion was enacted with the ACA, the share of ED patients without insurance has fallen from 16% in 2013 to 12% in 2014 and 10% in 2015. Meanwhile, ED utilization rates increased more quickly in states that did not implement Medicaid expansion than in states that did.
The results of the Deloitte study suggest that ACA measure to improve utilization of primary care services are working. However, ED utilization rates aren’t falling at an especially quick rate. These may continue to fall as patients become less reliant on inpatient care and turn more to outpatient services.