California Healthline Daily Edition

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Medi-Cal Expansion Correlates With Spike in ED Visits, Data Show

The number of Medi-Cal beneficiaries who visited the emergency department increased by about 50% from 2013 to 2014, according to data from the Office of Statewide Health Planning and Development, Payers & Providers reports.

Medi-Cal is California's Medicaid program.

Details of Data

According to the OSHPD data, nearly 800,000 Medi-Cal beneficiaries visited the ED in the first quarter of 2013. By the fourth quarter of 2014, that number increased to about 1.16 million.

Observers say the increase correlates with the expansion of the state's Medicaid program under the Affordable Care Act. Under the expansion, Med-Cal enrollment increased from 8.6 million in fall 2013 to about 11.3 million in late 2014.

Meanwhile, the data also show that the number of uninsured ED visitors decreased from about 450,000 in Q3 2013 to about 278,000 in Q4 2014.


Anthony Wright, executive director of Health Access, said, "There is a direct correlation with the expansion of Medi-Cal in 2013 and early 2014" and increase in ED visits, adding, "[T]his is what you would expect."

In addition, Wright said that many uninsured ED visitors also might be "booked as Medi-Cal," particularly if the hospital is participating in the state's Medi-Cal presumptive eligibility program.

Meanwhile, Jan Emerson-Shea, vice president of external affairs at the California Hospital Association, said, "It appears that there is nearly a one-to-one correlation between the drop in uninsured [ED] visits and the increase in Medi-Cal [beneficiaries] seeking care in the [ED]. We believe that this may well be attributed to the ACA."

Emerson-Shea noted that the increase in ED visits among Medi-Cal beneficiaries also might be related to low-reimbursement rates, which could limit "access to a physician" (Shinkman, Payers & Providers, 4/29).

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