Why Medicaid Patients Go to the ER, and Other News
Why Medicaid patients go to the hospital emergency room: they can’t get care anywhere else.
Obama budget defeated 99-0 in Senate.
Tag: "ER"
May 22, 2012 | 4 comments | by John Goodman
Medicaid Stops Paying for Non-ER, ER Care
The new cuts, set for April 1, focus on about 500 diagnoses including common infections, mild burns, strains and bruises. If an enrollee comes to an emergency room and is diagnosed with one of these conditions, the Washington Medicaid program won’t pay the hospital and doctors…Some 43 states have Medicaid initiatives designed to deter unnecessary use of emergency rooms, according to the Kaiser Family Foundation, a nonpartisan, nonprofit organization that studies health issues. Several states now charge patients copays for nonemergency services in an ER…
“If you fall down the stairs, and your ankle is twice its normal size, and I X-ray it and it’s broken, they’ll pay me, and if I X-ray it and it’s not broken, they won’t,” said one doctor.
Full article by Anna Wilde Mathews on this plan by Medicaid to stop paying for certain emergency-room visits in The Wall Street Journal.
Feb 28, 2012 | 4 comments | by John Goodman
Once People Have Health Insurance, They Will Seek Care…
At the emergency room!
New research in the Archives of Ophthalmology warns hospitals to prepare for an overload of emergency department (ED) visits after health reform kicks in. Florida hospital EDs already saw patients eligible for Medicaid jump 6 percent between 2005 and 2009, well before millions of Americans are expected to gain health insurance in 2014, reported The Tampa Tribune.
Meanwhile, approximately 68 percent of emergency physicians in Massachusetts saw an uptick in visits due to the state’s universal health plan, the model for national health reform, according to a 2009 survey, noted The News-Press.
Source: FierceHealthcare
Jan 16, 2012 | 6 comments | by John Goodman
Caplan on Gruber
Jon Gruber has written a graphic novel. This is from Bryan Caplan’s devastating review:
3. More generally, Gruber ignores almost everything government does to increase the cost of health care. There’s no discussion of medical licensing versus certification. There’s no discussion of the regulatory barriers to low-cost, high-deductible policies. There’s no discussion of medical liability. He mentions the high cost of “free” emergency room care, but fails to mention that this is a side effect of long-standing populist policy: government forces emergency rooms to treat people even if they certainly won’t pay.
4. There’s zero discussion of moral hazard – the unhealthy lifestyles that many people choose despite the risks. For Gruber, or at least Gruber the graphic novelist, bad health is something that “just happens to you.” Sigh. Insurance companies aren’t omniscient, but they could do a lot more to tailor rates to risks – if it were legal to do so. And maybe people would respond to those incentives by living healthier lives.
Entire review is worth reading.
Jan 04, 2012 | 8 comments | by John Goodman
Nursing Pays
The U.S. Bureau of Labor Statistics (BLS) predicts that the registered nurse (RN) will be the fastest growing profession between 2008 and 2018. And the profession is financially rewarding. The BLS estimates that the average salary for a registered nurse in 2010 was $67,720, or $32.56 an hour. In 2009 the average salary was $63,750, or $30.65 per hour. That’s about a 6 percent increase in a bad economy when millions of Americans were just thankful to have a job.
However, as in all professions, some segments do better than others. A recent survey of 3,000 nurse practitioners conducted by “Advance for NPs and PAs” found full-timers earned $90,770 in 2010. But nurse practitioners in emergency departments earned on average $104,549. Good salaries considering that Medscape reports that nearly half of family physicians, with all their additional training and educational expenses, made between $100,000 and $175,000 in 2010.
See full Merrill Matthews post at The Health Care Blog.
Dec 29, 2011 | 5 comments | by John Goodman
What Does an HMO Emergency Room Look Like?
In the editorial, the ER docs — who are from several large institutions — also warn that increased pressures on emergency physicians to save money could raise the probability of missed diagnoses, and boost medical-liability risks. ER physicians, who often make the decisions to admit patients to the hospital, will also face challenges given that hospitals are under pressure to limit admissions and readmissions, the editorialists contend.
Dec 09, 2011 | 4 comments | by John Goodman
The New Model of Urgent and Not-So-Urgent Care
Charlotte, N.C.-based Carolinas HealthCare System, for example, operates 32 hospital emergency departments, four freestanding ERs with five more planned, and 19 urgent-care centers. It is considering starting retail clinics in grocery or drugstores. “We can integrate care across a broad spectrum of settings and we have an electronic medical record that links all our patients no matter where they go,” says president and chief operating officer Joseph Piemont.
Full article on urgent care clinics.
Dec 07, 2011 | 7 comments | by John Goodman
Saturday Night Special?
This Phil Galewitz piece ran in the Washington Post back in August, but it’s still timely:
“Many hospitals are actively recruiting people to come to the ER for non-emergency reasons,” said Anthony Keck, South Carolina’s Medicaid director, citing facilities that tout their speedy ER service on highway billboards. “When you are advertising on billboards that your ER wait time is three minutes, you are not advertising to stroke and heart attack victims,” he said.
Dallas-based Tenet Healthcare Corp., a large hospital chain some of whose facilities have seen a surge of patients using the ER for primary care, recently began accepting online appointments to make it easier for patients to use the ER. It’s also promoting average waiting times on the Internet and on billboards…
Medicaid officials in Washington state were so concerned by hospitals’ ER marketing that they issued new rules making it harder for hospitals to qualify for Medicaid bonus payments if they promote their ER for primary care. “They sure don’t help us when we are trying to get word out that the ER is not the place you go for primary-care diseases like treating asthma or diabetes,” said Jeffrey Thompson, chief medical officer for the state Medicaid program.
HT to Trudy Liberman at The Health Care Blog.
Oct 24, 2011 | 3 comments | by John Goodman
Hospital ER Visits Up Since Mass Health Reform Enacted
To determine whether any changes in ED utilization in Massachusetts reflected the effect of Massachusetts’ reform or were merely representative of broader regional trends in ED utilization, we used New Hampshire and Vermont as control states…
The data on combined inpatient and outpatient ED [Emergency Department] use (top graph) suggest that the Massachusetts reform did not change the state’s trend in total ED utilization relative to that in states where no such reform was enacted. The continuous upward trend in ED utilization throughout the three periods is remarkably consistent from state to state; if we didn’t know which state had implemented the reform law, we could not guess on the basis of these data….. In summary, ED use increased in Massachusetts after reform but also increased by similar amounts in New Hampshire and Vermont, states that did not implement insurance expansions.
Sep 19, 2011 | 5 comments | by John Goodman
