Hospital Emergency Rooms and Medicaid

Hospitals seek more ER patients even as Medicaid tries to lessen demand, By Phil Galewitz, August 22, 2011, Washington Post: “Complaining of abdominal discomfort and chronic bronchitis, 22-year-old Toshia Johnson, an unemployed mother on Medicaid, went to a hospital emergency room in Bend, Ore., more than two dozen times in the year that ended in June 2010. She was never admitted to the hospital and used the ER for routine care because, she says, it’s near her home and the care was free. But in the first six months of this year, after entering a state-funded program designed to reduce unnecessary ER use by Medicaid patients in central Oregon, Johnson has gone to the ER just once, after breaking her tailbone. In the first half of this this year, ER visits by the 400 patients in this program have declined by more than half from the same period last year, saving Medicaid $1 million, officials say. Efforts to reduce unnecessary ER visits by patients in Medicaid, the joint state-federal health program for the poor and disabled, are proliferating as states search for ways to control the soaring costs of the program. But state officials complain that their efforts are sometimes hampered by hospitals’ aggressive marketing of ERs to increase admissions and profits…”