Myth: Much of Medicaid patients’ ED use is unnecessary.
Reality: False. Ninety percent of visits by nonelderly patients are for urgent symptoms or serious medical conditions that require immediate attention.
Myth: ED use among Medicaid patients is increasing.
Reality: Unclear. The data is conflicting. Patient-reported visits are no higher, though hospital administrative data shows adult Medicaid visits are increasing.
Myth: Medicaid patients use the ED because they have difficulty scheduling with their regular provider.
Reality: True. This reason accounts for nearly one-third of all ED visits by Medicaid patients.
Myth: Better primary care access would lower Medicaid patients’ ED usage.
Reality: True. While it may not impact super-utilization, individuals that use the ED without also using other specialty care services on a regular basis could benefit from better primary care access.
Myth: ED use will balloon with the 2014 Medicaid expansion.
Reality: Unclear. While there are several case studies, including in Oregon, Massachusetts and California, how Medicaid expansion affects ED use will vary state-by-state, according to the status of that state’s healthcare provision.
