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

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