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PwC: ER use in Arkansas has dropped

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A handcrafted health insurance coverage expansion strategy in Arkansas may be helping the state increase access to primary care services.

Analysts at the PricewaterhouseCoopers (PwC) Health Research Institute talk about the effects of the Arkansas coverage expansion program while looking at the Patient Protection and Affordable Care Act (PPACA) Medicaid expansion program. The analysts note that officials in 26 states and the District of Columbia agreed to use PPACA Medicaid expansion money to help residents with moderately low incomes “get covered.”

PPACA drafters expected states to use the money to expand Medicaid. Arkansas officials won permission from the U.S. Department of Health and Human Services (HHS) to use much of the “Medicaid expansion” money to help moderate-income residents pay for individual qualified health plan (QHP) coverage from the PPACA public exchange system.

In the first half of the year, in all jurisdictions that took the PPACA coverage access expansion money, the percentage of hospital patients who were uninsured or who said they would pay their bills out of their own pockets, was down 47 percent, the analysts say. In Arkansas, the percentage of hospital patients classified as uninsured fell about 30 percent.

A hospital group was expecting an uptick in the use of hospital emergency rooms, but the number of ER visits was down 2 percent, the analysts say. The analysts say the Arkansas Hospital Association believes newly insured residents are using ER services less because the moderate-income consumers with QHP coverage are having an easier time seeing primary care doctors than they did when they had no coverage or when they had traditional Medicaid coverage. Doctors in some states have complained about stingy QHP reimbursement rates, but, for now at least, Arkansas doctors seem to see QHP reimbursement rates as being more attractive than Medicaid reimbursement rates.


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