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"Take Me to the Emergency Room"

Doctor with pens

A 2014 18-month study followed 25,000 low-income Oregonians who won Medicaid coverage in a lottery as part of the Oregon Health Insurance Experiment found that expanding health coverage increases emergency room use. If the finding holds true, it could undercut an argument for the new health care reform law. The claim is that it was seen across all types of visits that could theoretically be handled in a “less-expensive” outpatient setting.

One of the tenets of the Affordable Care Act is that by providing insurance to everyone; this would be lead to limited Emergency Department utilization. The problem is very complex and the government solutions do not reflect the behavior patterns of the healthcare consumer.

A respected Emergency Department and Urgent Care billing consulting company felt that Emergency Department Visits would increase by 10-20 % and that the self-pay rate would increase from 18-20% to 30%. This is a reflection of increased Medicaid access and patients having to deal with $5-10,000 deductibles. These deductibles turn an insured patient into a de facto self-pay.

The consumers have voted with their feet in the last 15 years and realized the Emergency Departments and Urgent Cares provide excellent care. They also realize that Emergency Departments cannot ask for “cash up front”. An alternative view to over usage of the ED is that the ED has for years been a significant factor in increased excellent health care and coverage. The government may rethink the whole ED dogma and make it a central clearing house that distributes to Urgent Cares, Family Practice, Internal Medicine and various specialties. With a revamping of the payment schedules, this could accommodate consumers and control costs.


Xpress Technologies provides a user-friendly Electronic Health Record and the ability to control billing costs through its Practice Management Module can help any type of practice increase efficiency, control costs and deal with present day challenges. With the influx of patients into the ED, urgent cares and private physician can expect to gain patients, if they are efficient. The consumer will starting looking for the most health care for the dollar when they have to write the checks themselves.

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