Or are they a sign of normal growing pains?
We know that one goal of the Affordable Care Act (ACA) is to reduce the number of emergency room visits
where treatment for non-emergencies is more expensive than if handled through a primary care provider. So a recently published study in the journal Science that shows emergency room visits by patients covered under Oregon’s pilot program have actually gone up instead of down seems troubling.
However, many experts are not at all surprised by this report. Washington state emergency medicine physician Stephen Anderson told ThinkProgress, “Anybody that’s followed the progress of the last 15 years or so shouldn’t be surprised by these findings. If you look at the initial rollout in Canada, if you look at the initial rollout in Massachusetts, there was pretty much across the board increased use of emergency services when the programs first went into effect.”
But this initial increase does not appear to be long-lived. A study of the Massachusetts program showed “reduced ER usage by between 5 and 8 percent, nearly all of which is accounted for by a reduction in non-urgent visits that could be treated in alternative settings.”
Oregonians are seeing a similar trend in their state. In 2012 Oregon received a Medicare waiver which allowed it to start treating people through coordinated care organizations (CCO) and begin the process of educating health care consumers to get their health care needs met through the use of primary care providers. As a result Oregon has seen emergency room visits by people served by CCOs decreased by 9 percent from 2011 and emergency room spending is down 18 percent from 2011.
It appears, with a little direction and understanding, people will make the choice to see a primary care provider and forego emergency room care.