Indiana push to cut ER visits sees mixed results

(WISH Photo/Kevin Ratermann)

INDIANAPOLIS (AP) — Emergency room visits to Indiana hospitals are climbing at some facilities despite the federal health care overhaul that was supposed to reduce them.

The Affordable Care Act was designed to reduce unneeded ER trips because patients with insurance could afford to get care before their condition became a crisis, the Indianapolis Business Journal reported.

That hasn’t been the case at Community Hospital East in Indianapolis, where the emergency room is on pace to see a nearly 5 percent increase in visits.

Scott Teffeteller, president of Community East, said patients often visit emergency rooms for conditions that could have been avoided if they had gotten checkups in physician offices or health clinics. He said that’s particularly true for those with chronic diseases.

“The emergency room isn’t always the best place to get care,” Teffeteller said.

Community East has seen its ER visits increase an average of 6 percent over the past five years. The hospital recently announced a $45 million expansion of its emergency room.

Though emergency room visits nationally are on the rise, some Indiana hospitals have seen the decline the Affordable Care Act was supposed to produce.

At Eskenazi Hospital in Indianapolis, ER visits are on pace to fall 6 percent this year, following a 7 percent decline last year. And at Indiana University Health’s Methodist Hospital, ER visits are on pace to fall 3.8 percent this year after a decline of 6.9 percent last year.

Keeping ER visits in check is good for patient health and, increasingly, for hospital finances.

The visits average $2,200, according to a study by the University of California-San Francisco last year. But the health-care overhaul law created rewards for hospitals that cut spending, which has led to the push to reduce ER visits.

Hospital executives aren’t sure if ER use will decrease as patients who are newly insured under the health overhaul get used to using providers outside the emergency room.

“We have seen an increase, and we explain that as pent-up demand. We see a decrease, and we say, ‘Oh, that’s high-deductible plans,'” said Dr. Lisa Harris, CEO of Eskenazi Health. “I think it’s all purely a matter of speculation at this point. We need more time to study it.”

Community East has launched a Patient Resource Center that has a social worker or case manager talk to those who visit the ER about community medical facilities. They also help patients sign up for health insurance or Medicaid.

“We’re trying to really educate our patients,” Teffeteller said. “We really want to change people’s minds about where they can go for care.”

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