PPACA driving up ER visits

The number of emergency visit rooms has increased since the implementation of the Patient Protection and Affordable Care Act — and most doctors expect it to get even worse over the next few years.

In a poll of some 1,800 emergency physicians by the American College of Emergency Physicians, nearly half said more patients have been coming through their ER doors since Jan. 1, when many of PPACA’s key provisions went into effect.

Another 27 percent said the numbers haven’t changed, while 23 percent said they’ve seen a decline in ER visits.

Over the next three years, 86 percent of these doctors believe emergency room use will increase. And what’s more, 77 percent say their ERs are not adequately prepared for significant increases in traffic.

The poll’s findings about increasing ER visits are noteworthy given the law’s promise that it would reduce costly emergency room visits, because it was designed to encourage patients to seek care in a doctor’s office or clinic settings. Though the fact that ERs are experiencing flooding isn’t surprising, given the number of newly insured patients, emergency room doctors say the increase points to a number of issues.

One such problem, doctors say, lies in the fact that physicians are in short supply and cannot properly deliver care to the vast numbers of newly insured patients.

The Association of American Medical Colleges predicts a shortage of 90,000 doctors by 2020.

“Emergency visits will increase in large part because more people will have health insurance and therefore will be seeking medical care,” said Alex Rosenau, president of ACEP.  

“But America has severe primary care physician shortages, and many physicians do not accept Medicaid patients, because Medicaid pays so low,” he said. “When people can’t get appointments with physicians, they will seek care in emergency departments. In addition, the population is aging, and older people are more likely to have chronic medical conditions that require emergency care.”