Emergency physicians in the U.S. have reported an increase in the volume of patients since January 1, 2014, when the Affordable Care Act requiring health insurance went into effect, and they are not confident that ERs across the country are prepared, according to a new poll.
“The reliance on emergency care remains stronger than ever,” said Michael Gerardi, MD, president of the American College of Emergency Physicians, in a statement. “It’s the only place that’s open 24/7, and we never turn anyone away.”
The college invited 24,427 member physicians to complete the poll, 2099 of whom did, for a response rate of approximately 9%. The poll was conducted to gauge changes in ED patient volume and care since the Affordable Care Act went into effect.
With the implementation of the ACA, 47% of emergency physicians reported a slight increase in the number of patients, and 28% reported significant increases in patient volume.
56% of emergency physicians reported an increase in the number of Medicare patients, and 70% fear their ED is not sufficiently prepared for an increase in patient volume. Despite these concerns, 83% have concerns about efforts being made by hospitals to reduce emergency visits; specifically, that patients will put off medical care or utilize facilities with less/poorer resources.
“There is strong evidence that Medicaid access to primary care and specialty care is not timely, leaving Medicaid patients with few options other than the [ED],” said Orlee Panitch, MD, chair of the Emergency Medicine Action Fund, which ordered the poll.
“In addition, states with punitive policies toward Medicaid patients in the [ED] may be discouraging low-income patients with serious medical conditions from seeking necessary care, which is dangerous and wrong.” Panitch continued.
Dr Gerardi cited concerns about the closure of hospitals and emergency care facilities in states that have not expanded Medicaid.
“Hospitals received less Medicare funding for charity care when the [Affordable Care Act] took effect, because more people were supposed to have health insurance coverage,” said Gerardi. “But in states that didn’t expand Medicaid, hospitals are hurting. For example, the closure of a hospital in Baton Rouge resulted in a crisis for another hospital that inherited all the patients, many of whom are uninsured, and now this hospital may close as well. The average reimbursement for a Medicaid patient in the [ED] is about $43.00, but it’s much lower in many states.”
Perhaps most alarmingly, 34% of the physicians polled have considered leaving the profession.
