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NEWS RELEASE
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May 4, 2015
mbaldyga@acep.org
Media Contact and
for complete poll results:
Mike Baldyga
202-370-9288
ER VISITS CONTINUE TO RISE
SINCE IMPLEMENTATION OF AFFORDABLE CARE ACT
WASHINGTON —Three-quarters of emergency physicians report that emergency visits are going up, according to a
new poll. This represents a significant increase from just one year ago when less than half reported increases. Rather
than trying to keep people out of emergency departments, policymakers need to recognize the value of this model of
medicine that people want and clearly need, according to the American College of Emergency Physicians (ACEP).
Most of the respondents to the poll report little or no reductions in the volume of emergency visits due to the availability
of urgent care centers, retail clinics and telephone triage lines. About 90 percent of more than 2,000 respondents also
say the severity of illness or injury among emergency patients has either increased (44 percent) or remained the same
(42 percent).
“The reliance on emergency care remains stronger than ever,” said Michael Gerardi, MD, FAAP, FACEP, president of
the ACEP. “It’s the only place that’s open 24/7, and we never turn anyone away. Rather than trying to put a moat
around us to keep people out, it’s time to recognize the incredible value of this model of medicine that people need.”
More than one-quarter (28 percent) report significant increases in all emergency patients since the requirement to have
health insurance took effect. In addition, more than half (56 percent) say the number of Medicaid patients is increasing.
These data correlate with another new report issued by Health Policy Alternatives, which found that efforts by
policymakers and health insurance plans to drive Medicaid patients out of emergency departments and into primary care
are not working. More than half of providers listed by Medicaid managed care plans could not offer appointments to
enrollees, despite a provision in the ACA boosting pay to primary care physicians treating Medicaid patients. The
median wait times was 2 weeks but over one-quarter of providers had wait times of more than a month for an
appointment.
“There is strong evidence that Medicaid access to primary care and specialty care is not timely, leaving Medicaid
patients with few options other than the emergency department,” said Orlee Panitch, MD, FACEP, chair of EMAF and
emergency physician for MEPHealth in Germantown, Maryland. “In addition, states with punitive policies toward
Medicaid patients in the ER may be discouraging low-income patients with serious medical conditions from seeking
necessary care, which is dangerous and wrong. ”
The report — commissioned by the Emergency Medicine Action Fund (EMAF) — is titled “Review of the Evidence on
the Use of the Emergency Department by Medicaid Patients and the Evolving Role of Emergency Medicine
Physicians.”
“America has severe primary care physician shortages, and many physicians will not accept Medicaid patients because
Medicaid pays so inadequately,” said Dr. Gerardi. “Just because people have health insurance does not mean they have
access to timely medical care.”
In addition, Dr. Gerardi raised concerns about the closure of hospitals and emergency departments in states that have not
expanded Medicaid.
“Hospitals received less Medicaid funding for charity care when the ACA took effect, because more people were
supposed to have health insurance coverage,” said Dr. Gerardi. “But in states that didn’t expand Medicaid, hospitals are
hurting. For example, the closure of a hospital in Baton Rouge resulted in a crisis for another hospital that inherited all
the patients, many of whom are uninsured, and now this hospital may close as well. The average reimbursement for a
Medicaid patient in the ER is about $43.00, but it’s much lower in many states.”
When asked what would happen if federal subsidies for health insurance coverage were to be eliminated in their states
— which might occur if the U.S. Supreme Court decides in favor of the plaintiff in King v. Burwell — 42 percent of
emergency physicians said they expect emergency visits to increase. Additionally, 65 percent expect reimbursement for
emergency care will decrease if those federal subsidies are eliminated.
Poll Methodology:
This survey was conducted online in the United States by Marketing General Incorporated on behalf of the American
College of Emergency Physicians between March 16-23, 2015, among 2,099 emergency physicians age 18 or older,
providing a response rate of 9 percent and a margin of error of 2.1 percent. To see the complete poll results, please
click here or contact Mike Baldyga at mbaldyga@acep.org or 202-370-9288.
About ACEP:
ACEP is the national medical specialty society representing emergency medicine. ACEP is committed to advancing
emergency care through continuing education, research and public education. Headquartered in Dallas, Texas, ACEP
has 53 chapters representing each state, as well as Puerto Rico and the District of Columbia. A Government Services
Chapter represents emergency physicians employed by military branches and other government agencies.
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