ED use grew after ACA's Medicaid expansion, study finds

The ACA's Medicaid expansion led to increased Medicaid visits to the hospital emergency department, according to an analysis from Brookings Papers on Economic Activity.

For the paper, researchers from Chicago-based Northwestern University, Nashville, Tenn.-based Vanderbilt University, Boston University and the Agency for Healthcare Research and Quality analyzed patient-level discharge data in 20 states from 2012-15 to study how Medicaid expansion affected hospital use.

The researchers found that greater access to insurance increased the use of hospital services. Large declines in ED use did not result from expanded Medicaid. In fact, increases in hospital use primarily reflected outpatient visits to the ED for potentially non-emergent treatment.

"Our results provide evidence that the market-wide impact of the ACA has been to increase the use of hospital services," the researchers said. "This increase primarily occurred through outpatient visits to the ED for conditions that might have been deferrable and treatable outside of the ED. Our preferred estimate suggests a 20 percent increase in the use of the hospital for the newly insured."

Read the full paper here.

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