Delayed medical care is a national problem that most emergency room doctors are all too familiar with.
Although recent polls have suggested that the number of people avoiding medical care due to cost has declined as more have gained insurance through the Patient Protection and Affordable Care Act, a new survey of emergency room physicians suggests that many who have insurance are still avoiding care because of their insurance plan's high out-of-pocket costs.
The poll of 1,433 ER doctors by the American Academy of Emergency Physicians found that 70 percent of ER doctors reported treating patients who have health insurance but have forgone necessary medical care due to cost.
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The study also revealed a troubling pattern in which patients end up in the ER because they can't find non-emergency doctors to treat them.
According to the poll, 80 percent of ER doctors report treating patients who said they were having trouble finding relevant specialists included in their health plan. Similarly, 73 percent report seeing increased numbers of Medicaid patients in the ER because insurers weren't providing enough primary care physicians or specialists.
The ER doctors themselves are having a hard time directing patients to more appropriate providers. Sixty percent report having trouble directing patients to specialists because of "narrow networks" designed by insurance plans. And two-thirds reported that primary care physicians were sending patients to the ER for tests or procedures because insurers were refusing to cover the cost during a routine doctor visit.
Finally, one-fifth of ER doctors say they have either considered or know colleagues who have considered dropping out of insurance networks. In more than 90 percent of cases, that decision is tied to pay and the perception that insurers are not offering fair reimbursements for services.
"Emergency patients are especially vulnerable because health plans know that emergency departments never turn anyone away," said Jay Kaplan, president of ACEP. "Health insurers have been taking gross advantage of patients and medical providers since the Affordable Care Act took effect, arbitrarily slashing reimbursements to physicians by as much as 70 percent. Patients and physicians should band together to fight these dangerous insurance industry practices."
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