The Affordable Care Act has been touted as a means to control costs and improve quality of care. One initiative in that effort is to steer patients away from visiting the emergency department (ED). That undertaking may prove to be challenging.
The Affordable Care Act has been touted as a means to control costs and improve quality of care. One initiative in that effort is to steer patients away from visiting the emergency department (ED). That undertaking may prove to be challenging, especially in light of a recent report which found that people in Oregon who gained coverage through Medicaid used the ED 40% more than those who were uninsured. These findings disprove the myth that suggests it is only the uninsured who end up getting treated in hospital EDs.
“I would view it as part of a broader set of evidence that covering people with health insurance doesn’t save money,” says Jonathan Gruber, a health economist at the Massachusetts Institute of Technology. “That was sometimes a misleading motivator for the Affordable Care Act. The law isn’t designed to save money. It’s designed to improve health, and that’s going to cost money.”
Additionally, some hospitals are building EDs specifically tailored to the aging population. While promising for elderly patients, who are more likely to have complex or chronic conditions and be readmitted, they may not be cost-effective. Senior-specific EDs costs can range from $150,000 to $3.2 million to operate, depending on the number of patients a hospital treats.
“Is this money being well spent? There are some instances where this might improve readmission rates. (But) true robust data is not yet available for outcomes for senior-specific EDs,” said Robert Maliff, director of ECRI’s Applied Solutions Group.
According to the ECRI Institute’s 2014 Top 10 Hospital C-Suite Watch List, there are 10 clinical developments, tools, and technologies that healthcare executives should be aware of, including EDs tailored to elder care. The group notes that the suggestions they offer are not a list of “must-haves,” but rather a list of “must-think-carefully-about” technologies and health-system issues. They suggest the following should be on hospital radars:
Around the Web
Growth of Senior-Specific EDs Holds Quality Promise but Raises Cost Issues [Modern Healthcare]
Study: Expanding Medicaid Doesn’t Reduce ER Trips. It Increases Them. [The Washington Post]
Oncology Onward: A Conversation With Thyme Care CEO and Cofounder Robin Shah
October 2nd 2023Robin Shah, CEO of Thyme Care, which he founded in 2020 with Bobby Green, MD, president and chief medical officer, joins hosts Emeline Aviki, MD, MBA, and Stephen Schleicher, MD, MBA, to discuss his evolution as an entrepreneur in oncology care innovation and his goal of positively changing how patients experience the cancer system.
Listen
What We’re Reading: Affordable Home Care; Mycoplasma Infections Rise; Opioid Crisis Settlement
December 4th 2023Families struggle to find affordable, reliable home health aides; reports of increased pediatric pneumonia cases; legal battle ensues over Purdue Pharma’s bankruptcy settlement.
Read More
Insufficient Data, Disparities Plague Lung Cancer Risk Factor Documentation
September 24th 2023On this episode of Managed Care Cast, we speak with the senior author of a study published in the September 2023 issue of The American Journal of Managed Care® on the importance of adequate and effective lung cancer risk factor documentation to determine a patient's eligibility for screening.
Listen
New Data Update Myasthenia Gravis Outcomes for Patients in Australia
December 3rd 2023Patients living with myasthenia gravis in Australia were surveyed their demographic information, clinical features of the autoimmune disease, adverse effects from treatment, and quality of life. Outcomes were compared against 2011 data from Australia and 2019 data from the United States.
Read More
NK Cell Therapy SNK01 Improves Cognitive Function in Alzheimer Disease for up to 11 Weeks
December 3rd 2023Among 10 patients evaluated, compared with their baseline at 1 week after receiving their final dose in the trial, 30% demonstrated clinical improvement on the Alzheimer’s disease composite score.
Read More