ED Advertising Comes Under Fire as States Aim To Curb Routine ED Use
State officials attempting to reduce unnecessary emergency department visits by Medicaid beneficiaries are criticizing hospitals' efforts to market EDs, saying the campaigns undermine states' cost-control initiatives, Kaiser Health News/Washington Post reports.
States have begun addressing Medicaid beneficiaries' use of EDs because they use them three times as much as privately insured individuals and twice as much as uninsured individuals, according to previous findings.
Genevieve Kenney, senior fellow with the Urban Institute, said beneficiaries seek care in EDs more often because they typically are sicker than uninsured or privately insured individuals. In addition, beneficiaries often have trouble finding a physician who accepts Medicaid, pushing them to instead use EDs. Further, beneficiaries typically can get care in EDs for little or no cost.
Some states are trying to reduce the number of Medicaid beneficiaries visiting EDs for non-emergency care by making them pay more out of pocket.
Washington state this year will halt reimbursements to hospitals for beneficiaries who are treated in EDs more than three times for non-emergency care.
Texas also is planning to reduce reimbursements for routine care performed in EDs. Meanwhile, Florida is seeking federal approval to charge Medicaid beneficiaries $100 for using EDs for non-emergency situations.
Hospital Marketing Campaigns
Meanwhile, some hospitals have launched aggressive ED marketing campaigns. HCA, the largest for-profit hospital chain in the U.S., launched an ED marketing campaign in Florida, Texas, Virginia and other states, which includes billboards and smartphone applications showing ED wait times.
Mark Foust, a spokesperson for HCA in Virginia, said it was not the chain's intention to attract patients who do not belong in EDs.
Meanwhile, Tenet Healthcare recently also began showing average ED wait times online and on billboards. Both HCA and Tenet have said they have no evidence to indicate that their campaigns are inappropriately increasing ED usage.
However, Anthony Keck, Medicaid director of South Carolina, countered, "When you are advertising on billboards that your [ED] wait time is three minutes, you are not advertising to stroke and heart attack victims."
Federal Findings Question State Initiatives
Some studies suggest that state efforts to quell non-emergency ED services might be unnecessary, KHN/Post reports. Recent CDC findings indicate that just 8% of ED visits are for routine care. The agency also said the frequency of individuals seeking non-urgent care was similar among Medicaid beneficiaries, privately insured and uninsured individuals.
In addition, researchers said it is difficult to measure whether an ED visit is truly warranted. For example, an individual who goes to the ED for a headache could be diagnosed with a minor problem, but the patient also could show early signs of a stroke.
The American College of Emergency Physicians said efforts to block Medicaid patients from EDs are misguided. Sandra Schneider, president of ACEP, said, "Most emergency patients are seeking emergency care appropriately" (Galewitz, KHN/Washington Post, 8/22).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.