Extending affordable health coverage to two groups targeted by the Patient Protection and Affordable Care Act may be working to reduce the medical costs of those patients.
The groups — young people under the age of 26 and Medicare patients enrolled in federally designated patient-centered medical homes — showed a slight reduction in the number of emergency room visits since they have had coverage.
The American College of Emergency Physicians released the information, drawn from two studies: one by researchers at Purdue University that concentrated on young people; and another from George Washington University that looked at the older population group.
Health care reform advocates has particularly wanted to extend coverage to these groups. Young people tended not to seek coverage prior to its greater availability under the law. The older group, a high-cost coverage niche, in theory now has better coverage that is in part designed to reduce ER visits.
While the studies did reveal fewer ER visits, it also found no change in ER visits that lead to hospitalization — the most expensive of ER trips.
“The concept of 'medical homes' has been around since the 1960s and reviews of their effectiveness in improving health outcomes have been mixed,” said lead study author Jesse Pines at the George Washington University School of Medicine and Health Sciences in Washington D.C. “Our study shows that these models can have a positive effect on patients, as far as limiting outpatient emergency department use, but they don’t seem to keep patients from being hospitalized, which is many times more expensive than ER visits.”
The study of those ages 19 to 25 with health coverage reported a decrease in ER visits of 1.6 per 1,000 people. Most of the decrease was attributed to young women making “weekday visits [for] non-emergency conditions and conditions that could be treated outside the emergency department,” the study said.
“The reductions in ER use among young people were quite specific to less severe conditions that could be handled in a primary care setting, which is not unexpected,” said lead study author Yaa Akosa Antwi of Indiana University-Purdue University in Indianapolis. “Overall, the reductions in ER use were modest, which suggests that even when the ACA is fully implemented, population-level changes in emergency department use may also be modest.”
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Dan Cook
Dan Cook is a journalist and communications consultant based in Portland, OR. During his journalism career he has been a reporter and editor for a variety of media companies, including American Lawyer Media, BusinessWeek, Newhouse Newspapers, Knight-Ridder, Time Inc., and Reuters. He specializes in health care and insurance related coverage for BenefitsPRO.
