info
What does PPACA do to the Emergency Department?
As a physician-in-training, specializing in Emergency Medicine — I thought I’d chime in on the Patient Protection and Affordable Care Act (PPACA). First off, this “mandate” everyone is talking about basically says if you can afford insurance but do not get it, you will be charged a fee — or in other words, taxed.
For some healthcare organizations, physicians, and hospital departments, today’s ruling will have significant implications — hospital emergency departments will be greatly affected.
In the ED, we’ll most likely experience a little increase in reimbursements, as 20 percent of the patients are uninsured. Basically, uninsured individuals, who have been paying for healthcare services independently —- the lowest form of reimbursement for hospitals and EDs —- will have access to insurance through Medicaid and state exchanges.
Aside from that, the EDs will most likely see volumes increase for two reasons.
First, the mere fact that more individuals will be covered by insurance will bring more patients to the ED, especially since the uninsured population has healthcare needs on reserve.
Second, there is not a primary care practice excess in the country. The odds are that newly insured individuals will not be able to see primary care practitioners and instead will visit an emergency room — thus contributing to even more emergency department overcrowding!
We already have our emergency departments full — when I’m in the ED, I constantly see beds in the hall. With PPACA, it will only lead to even more ED crowding, poorer access to emergency care for the truly vulnerable, and more losses for hospitals. It’s not just about the money — if we’re turning patients away due to capacity constraints, we won’t be able to provide adequate emergency care.
