NEJM Authors Seek Solutions to Keep Medicaid Clients out of the Emergency Department

One promise of Medicaid expansion is the opportunity to keep those who previously lacked insurance from seeking routine care in the emergency room. In time that may happen, but in the short term it’s not always the case, as authors discuss in commentary published today in the New England Journal of Medicine.

For a variety of reasons, many newly insured continue to seek care where they always have: in the emergency department (ED). Some cannot find a primary care doctor who will take Medicaid; others have always gone to the ED and don’t know another way.

What is clear, according to authors Ari B. Friedman, MS, Brendan Saloner, PhD, and Renee Y. Hsia, MD, is that a sizable share of these new Medicaid beneficiaries have pent-up healthcare needs that are being addressed at great cost. As a study in Oregon found, many newly insured are increasing their ED use, at least temporarily.