Navigation Links
GW researchers examine increased ER reimbursements after ACA insurance coverage expansions
Date:10/28/2013

WASHINGTON (Oct. 28, 2013) Researchers at the George Washington University School of Medicine and Health Sciences (SMHS) found that outpatient emergency department encounters could reimburse considerably more after implementation of the insurance coverage expansions of the Affordable Care Act (ACA).

The study, published in Annals of Emergency Medicine, examined data from 2005-2010 from the Medical Expenditure Panel Survey, a publicly available dataset from the Agency for Healthcare Research and Quality. Co-authors Jesse M. Pines, M.D.,M.B.A, director of the Office for Clinical Practice Innovation and professor of emergency medicine and health policy, and Jessica Galarraga, M.D., M.P.H., a third-year emergency medicine resident, both at SMHS, looked at how emergency department reimbursements may be impacted as uninsured patients gain new coverage through the Medicaid expansion or health insurance exchanges. Assuming historical reimbursement patterns prevail after the ACA implementation, they found that outpatient emergency department encounters could reimburse more for both previously uninsured patients who will obtain Medicaid insurance and for those who move into private insurance products through health insurance exchanges.

"The motivation for this project was to estimate how reimbursement patterns may change with the upcoming insurance expansion under the Affordable Care Act and to provide insight on its implications on the economic health of emergency departments after health reform," said Galarraga.

The authors estimated the amount of money that emergency departments might have collected for uninsured patients, had they possessed the insurance they will likely obtain post-reform for encounters where the patient is not admitted to the hospital. For the uninsured who will be eligible for Medicaid insurance, reimbursement would have been 17 percent higher on average per visit if they actually had Medicaid insurance. For uninsured patients who will be Medicaid-ineligible (i.e. those who will be expected to obtain insurance on the private market or through health insurance exchanges after reform is implemented), reimbursement would have been 39 percent higher per visit if they had private insurance.

According to Pines, whether the changes that come along with the ACA will impact the financial health of emergency departments and hospitals is the critical question everyone is asking. "Our study sheds some light on this by showing that payments may actually increase for outpatient emergency department visits. Yet, there are still many unanswered questions, such as how visit volumes will change, and how new payment models that move away from paying for every visit, might impact the business model of emergency departments," said Pines.


'/>"/>

Contact: Lisa Anderson
lisama2@gwu.edu
202-994-3121
George Washington University
Source:Eurekalert

Related medicine news :

1. U of M researchers identify key proteins influencing major immune strategies
2. Researchers detail possible resistance mechanisms of colorectal cancer to bevacizumab (Avastin)
3. Carnegie Mellon and University at Buffalo researchers improving transit for people with disabilities
4. Researchers discover a new protein fold with a transport tunnel
5. Mount Sinai Researchers Identify Mechanisms and Potential Biomarkers of Tumor Cell Dormancy
6. Study by researchers at Saarland University demonstrates preventive effect of sterols in Alzheimers
7. Neurotoxin effectively relieves bone cancer pain in dogs, Penn researchers find
8. Mount Sinai Researchers Find Value -- and Limitations -- of Patient Assistance Programs for Women with Breast Cancer
9. Researchers propose social network modeling to fight hospital infections
10. BUSM researchers make a case for free fatty acids
11. Researchers launch first-ever phase II safety study of rectal microbicide to prevent HIV
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:5/5/2016)... ... May 05, 2016 , ... Linfield College Online and Continuing Education ... by waiving the $50 application fee for all qualified applicants from May 1–14. Students ... Waiver option when applying . , With the RN to BSN ...
(Date:5/5/2016)... ... May 05, 2016 , ... Is the part in your hair ... a few days away, it’s a good opportunity to raise awareness about a common ... Academy of Dermatology, 40% of women experience hair loss or ‘thinning’ by the time ...
(Date:5/5/2016)... ... May 05, 2016 , ... The Wisconsin ... Lombardo, PT, DPT, MA, OCS, WCS, has been selected by the Wisconsin Physical ... The WPTA Private Practice Award is awarded annually to a member of the ...
(Date:5/4/2016)... ... , ... Mother Nature isn’t the only mom that loves the garden. Mothers ... Celebrate these women with more than just a bouquet of flowers. Give mom, or ... , Vibrant, Edible, Compact Plants from BrazelBerries: , For a gift that adds ...
(Date:5/4/2016)... ... May 04, 2016 , ... Trinity Health ... fund and implement ideas aimed at improving care and reducing readmission rates for ... our vision for Trinity Health is to drive innovation that transforms our ministry ...
Breaking Medicine News(10 mins):
(Date:5/3/2016)... , May 4, 2016 Research ... "Global Cancer Stem Cell Therapy Market Outlook 2020" ... http://photos.prnewswire.com/prnh/20160330/349511LOGO ) , ,Recombinant technology has improved significantly ... expected to be developed in coming years. Many cancer ... Cancer stem cell therapies are also expected to be ...
(Date:5/3/2016)... 2016  While you may be familiar with watching a film or TV show in high ... or 8MP in the Medical Industry.  Ampronix  is a renowned authorized reseller of the medical ... Photo - http://photos.prnewswire.com/prnh/20160502/362730 ... ... ...
(Date:5/3/2016)... 2016  Specialty Silicone Fabricators is offering teachers ... a cleanroom works. The free visual aid provides ... technology. Chris Mazelin , ... SSF enthusiastically supports the Science, Technology, Engineering and ... next generation of innovators. We want to provide ...
Breaking Medicine Technology: