Medicaid Use May Boost ER Visits, Study in Oregon Suggests

Expansion of public insurance plan unlikely to reduce urgent care, researchers say

By Randy Dotinga

Thursday, January 2, 2014

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THURSDAY, Jan. 2, 2014 (HealthDay News) -- New research reveals that Oregon residents covered by Medicaid -- the publicly funded health insurance program for the poor -- are 40 percent more likely to use emergency rooms than people with no insurance.

This finding suggests that expansion of Medicaid, which some states are allowing under the Affordable Care Act, could lead to more use of emergency departments instead of less, researchers said.

"Although one always needs to be careful generalizing to other settings, these results suggest that other Medicaid expansions are unlikely to decrease emergency room use," Amy Finkelstein, a professor of economics at Massachusetts Institute of Technology and a principal investigator of the study, said in a university news release.

"When you cover the uninsured, emergency room use goes up by a large magnitude," Finkelstein noted. "In no case were we able to find any subpopulations, or type of conditions, for which Medicaid caused a significant decrease in emergency department use."

The study, published Jan. 2 in the journal Science, revealed that people with Medicaid used the emergency room more for a variety of reasons, even for conditions that might be more easily treated in a doctor's office.

For the study, the researchers tracked emergency department records of 25,000 Oregon residents over 18 months. Oregon expanded Medicaid in 2008 with the help of a lottery system that allowed 10,000 of 90,000 applicants to get coverage.

SOURCE: Massachusetts Institute of Technology, news release, Jan. 2, 2014

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