Insurance expansions reduce ER Use

One promise of the Affordable Care Act (ACA) was that by giving more people access to health insurance, patients would be more likely to have a regular source of care and would be less likely to use the emergency room. Rick Kronick–the Director of the Agency for Healthcare Research and Quality (AHRQ) and a member of my dissertation committee–cites new research from the Annals of Emergency Medicine that finds that emergeny room visits have fallen. Kronick writes:

A new study, published today in the Annals of Emergency Medicine, shows that, following the implementation of the Affordable Care Act, the annual rate of emergency department visits by young adults age 19 to 25 decreased by 1.4 percent in 2011.

This represents 191,000 fewer emergency department visits among young people in this age group than would have occurred if the rate of emergency department use had not decreased. The data show decreases in weekday visits, non-urgent conditions, and conditions that could be treated in places other than the emergency departme

Of note, the authors find the ACA had no effect on weekend ER visits, likely because even insured patients have limited access to primary care physicians on the weekend. The authors conclude that “The Patient Protection and Affordable Care Act dependent coverage expansion was associated with a statistically significant yet modest decrease in ED use, concentrated in the types of ED visits that were likely to be responsive to changes to insurance status.”

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