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Study: Medicaid patients use ER 40% more often than uninsured

BY Michael Johnsen

CAMBRIDGE, Mass. — Adults who are covered by Medicaid use emergency rooms 40% more than those in similar circumstances who do not have health insurance, according to a new study co-authored by an MIT economist that sheds empirical light on the inner workings of health care in the United States.

The study takes advantage of Oregon’s recent use of a lottery to assign access to Medicaid, the government-backed healthcare plan for low-income Americans, to certain uninsured adults. The research examines emergency room records for roughly 25,000 people for a period of 18 months.

"When you cover the uninsured, emergency room use goes up by a large magnitude," said Amy Finkelstein, the Ford Professor of Economics at MIT and a principal investigator of the study, along with Katherine Baicker, a professor at the Harvard School of Public Health.

The study, which was published Thursday in the journal Science, also documented that having Medicaid consistently increases visits to the emergency room across a range of demographic groups, types of visits and medical conditions, including types of conditions that may be most readily treatable in primary-care situations.

"In no case were we able to find any subpopulations, or type of conditions, for which Medicaid caused a significant decrease in emergency department use," Finkelstein said. "Although one always needs to be careful generalizing to other settings, these results suggest that other Medicaid expansions are unlikely to decrease emergency room use."

With the implementation of the Patient Protection and Affordable Care Act, Medicaid is expanding in many states to cover a population similar to the one that gained Medicaid through Oregon’s lottery. The results in this paper, however, suggest nuances to the current debates over the expansion of Medicaid, medical costs and the role of emergency rooms in providing care.

On one level, the results accord with a traditional economics framework suggesting that insurance, by lowering out-of-pocket costs, would increase the use of medical care. Or, as Finkelstein observed, "If we’ve lowered the price of the emergency department, we would expect people to use it more."

However, Medicaid also lowers the out-of-pocket costs of other types of health care, such as primary-care doctors. Some policy analysts have suggested that expanding Medicaid could reduce emergency department visits by the formerly uninsured by bringing them into more regular contact with primary-care doctors and clinics for preventive care. In theory, that could also reduce overall system costs, since urgent care is expensive.

Prior work by Finkelstein, Baicker and others on Oregon’s lottery applicants showed that people who obtain Medicaid increase their use of primary and preventive care. But, as Finkelstein pointed out, the net effect of Medicaid in the study was to also increase use of emergency services.

 

 

 

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J.KESSLER says:
Jan-06-2014 02:13 pm

Part of this study should have examined the number of primary care physicians and clinics that will accept state Medicaid. If more standard facilities would accept Medicaid patients, then the E.R. visits would decrease. Rural and suburban areas are most effected by the lack of Medicaid acceptance. At least, this is true for Maryland.

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Zak introduces ‘Dragon’-themed dinnerware

BY Ryan Chavis

SPOKANE, Wash. — Kids (and kids at heart) have even more reason to be excited about the upcoming film "How to Train Your Dragon 2," thanks to Zak Designs. 

Zak, a leading manufacturer of licensed children’s dinnerware, introduced a line of meal-time products featuring characters from the movie and television show.

To help capture all the excitement of the film at the dinner table, fans can expect a three-section tray, flatware set and a 14.5-oz. tumbler. "How to Train Your Dragon 2" is set to be released in June.

 

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Razer introduces new headphone series

BY Ryan Chavis

CARLSBAD, Calif. — Razer, a producer of high-performance gaming hardware, software and systems announced the Razer Adaro series, a new line of headphone designed for entertainment. 

The new line will feature four different earphone models: bass-heavy, analog stereo, Bluetooth and DJ-style. Each set of earphones is designed with an eye toward durability and comfort, as well as exceptional sound quality. The Razer Adaro series marks the company’s latest foray into the personal entertainment audio space. 

"Making technically advanced headsets to meet the extraordinary requirements of professional gamers has been a primary focus for us for years, and applying that competency to the development of headphones designed for music lovers is a natural extension for the business and our fans," Min-Liang Tan, Razer co-founder, CEO and creative director, said. "For some time now, we’ve been asked to come out with a line of headphones that addresses the other interests of our community. The Razer Adaro lineup offers just that: high-quality, portable audio for kicking-back, traveling and training, and even for making music."

All four Razer Adaro products are currently available for pre-order. Visit RazerZone.com for more information.

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