Study Finds Correlation between Expanded Health Care Coverage and ER Visits

One of the first studies to grab headlines in the new year found that those who were covered by Medicaid made more emergency room visits than their counterparts who did not have health insurance. For the medical billing and coding industry, more ER visits translates into more work, and as expanded Medicaid coverage is one of the pillars of the Affordable Care Act this most recent study can be interpreted as good news for the profession.

To conduct the study, researchers looked at figures stemming from Oregon’s Health Plan lottery which involved about 90,000 participants. Beginning in 2008 around one-third of applicants in this lottery were awarded expanded Medicaid coverage, and these recipients were compared with the roughly two-thirds of applicants who did not receive the expanded benefits. What researchers discovered was that those with the expanded Medicaid coverage were 40 percent more likely to visit the emergency room; 35 percent of those with no insurance paid a visit to the ER while 42 percent of their insured counterparts did the same. Around 10,000 of the insured group were newly insured.

While many were quick to diffuse the political implications this correlation could have – the widely held assumption that having insurance coverage would decrease emergency room visits, one of the touted benefits of the Affordable Care Act – the associated advantages for medical billing and coding professions is less contentious.

Sponsored Content

Since the Supreme Court ruling that allowed states to choose whether they wanted to opt in to Medicaid expansion, only half have chosen to do so, however more are expected to follow as the ACA catches on. As this happens and an increasing percentage of previously uninsured Americans gain coverage, the demand for medical billing and coding services is expected to rise.

Don’t forget that these people with expanded Medicaid coverage have also been making appointments with regular physicians and increasing their stays in hospitals. This falls into line with earlier studies performed by the same researchers which concluded people with healthcare coverage were more prone to use health services as a whole.

Political quips came from both supporters and detractors of the Affordable Care Act, with those opposed citing the rule that if something costs less it will be consumed more, while proponents pointed out that in Oregon physicians accepting Medicaid are harder to find and their waiting lists can be months long.

Because this study is only focused on one state it has yet to be seen how applicable these results are for national trends. Oregon’s Medicaid program is similar to those of many other states, covering visits to the ER, doctor’s offices, prescription drugs, and hospital stays. Oregon’s population demographics are also similar to the rest of the nation’s except that it has a lower percentage of minorities. In this study, it was found that men were more likely than women to make increased visits to the ER.

Researchers from the Harvard School of Public Health and the Massachusetts Institute of Technology participated in this mos recent study which appeared in the journal “Science.”