A newly published study in Annals of Emergency Medicine has shown how Medicaid Expansion has affected 25 states since the enaction of the Affordable Care Act (the ACA) in 2014. While many had hoped that expanding Medicaid would alleviate some of the overuse of EDs in the states that offered the expansion, others predicted that access to insurance would increase usage of all medical care, including EDs.
Medicaid Expansion States Saw ER Visits Go Up
The study has shown that in states that expanded Medicaid coverage under the the ACA saw 2.5 emergency department visits more per 1,000 people after 2014, while the share of emergency department visits by the uninsured decreased by 5.3 percent. The share of visits covered by private insurance remained constant for expansion states and increased by several percentage points for non-expansion states.
Today, we sat down with our CEO, Dr. Charles Duva, who addressed these payer mix changes. “These changes in coverage have generally had positive effects on physicians and hospitals. In states that expanded Medicaid, physicians have experienced shifts in payer mix from uninsured to Medicaid, leading to reductions in physician uncompensated care and improved financial positions therefore increasing receipts per patient.” Dr. Duva adds that “the changes for the most part have been financially rewarding but at this time, with the new administration and a Republican Congress, there is much left up in the air as to continuing the same level of federal Medicaid financing. The financing burden may be shifted at the state level on a state-by-state case. Our opinion is that this will lead to reduced reimbursement and/or fewer people insured with Medicaid, essentially affecting the payer mix more towards self-pay.”
“the changes, for the most part, have been financially rewarding”
The team here at DuvaSawko is dedicated to effectively managing these types of changes in payer mix. Contact us today to discuss how these changes could potentially affect your practice, and to get more perspective on ways we can help your group increase your revenue by up to 30%.