There were many predictions in 2013 leading up to the initial implementation of the Affordable Care Act in 2014, one of the most groundbreaking pieces of health care legislation in decades that affected many medical billing challenges, including emergency services. Although some of these estimates proved true, while others proved false, the rates may be increasing when it comes to emergency room visits under Obamacare.

"When [newly insured] people can't get appointments with physicians, they will seek care in emergency departments," American College of Emergency Physicians president Dr. Alex Rosenau explained to Fierce Healthcare. "In addition, the population is aging, and older people are more likely to have chronic medical conditions that require emergency care."

ACA originally a 'tonic' for overworked ERs
It wasn't too long ago that many medical professionals believed the ACA would be a useful tool in reducing the amount of U.S. ER visits. CBS reported in September 2014 that the number of uninsured Americans receiving ER services had been increasing steadily over time, mainly because hospitals were the main source of primary care for this demographic, even during nonemergency situations.

At first, it seemed that the legislation was working, at least for young people. According to a Stanford University study published in Health Affairs, data on adults between the ages of 19 and 25 in California, Florida and New York (some of the most heavily populated U.S. states), ER visits were on the decline.

ER use rises in the heartland
Kentucky is one state caught in the middle of this health care debacle. According to a 2014 USA Today publication, a majority of hospitals in the Bluegrass State are seeing an increased amount of newly insured Medicaid recipients choosing the ER as their standard mode of primary care, which is putting extra strain on ER staff.

"We're seeing patients who probably should be seen at our (immediate-care centers)," Lewis Perkins, vice president of patient care and chief nursing officer at Norton Hospital in Louisville, Kentucky, explained to USA Today. "And we're seeing this across the system."

Mike Rust, the president of the Kentucky Hospital Association, told the source that the same trends are occurring across the state. Officials believe there are many reasons why this phenomenon keeps happening:

  • Doctor shortages may be contributing to the rising numbers. Some primary care physicians simply can't keep up with the amount of newly insured patients.
  • ERs offer 24-hour access. Poor individuals often can't afford to take time off work for daytime appointments. ERs, however, are open around the clock and cater more to their schedules.
  • Many patients who have been without insurance over the years are used to ER care even though it may cost more in terms of physician billings. What's more, some may not have regular doctors.

No matter what kind of situation is happening in your region when it comes to ER visits, all practices should be equipped with the best possible medical billing and coding services in order to keep up with these rising numbers.