By some measures, at least, you can claim that the Health Reform is working. I’ve seen a few articles out there saying it failed, because ED visits continue to rise. But, if this study is reliable, the increases in ED utilization are a result in increased illness severity, not inability to access a physician.
Non-acute visits for the uninsured/low-income cohort in Massachusetts went down, from 43.8% to 41.2% – a greater decrease as compared to their “control” group of private insurance that is supposedly unaffected by health reform, which decreased from 35.7% to 34.9%. So, one way to interpret this is that increased access has kept some of the non-urgent uninsured out of the ED.
…but they’re still seeing, by their definition, a solid nearly 40% of patients in our EDs that have less than a 25% of requiring true Emergency Department care. So things have incrementally improved – but the problem is not simply that a patient has nominal access to a PMD, they actually need to be able to access that PMD on a semi-urgent basis to truly reduce ED utilization…and that PMD needs to be more than simply a revolving door back to the ED.