Reform To Exacerbate Emergency Department Crowding, Experts Say

The new health reform law might exacerbate emergency department overcrowding, according to health care facility experts, The Hill reports.

Advocates of the overhaul said the law would help address ED overcrowding by ensuring more U.S. residents had insurance to cover physician visits.

However, EDs likely will experience higher patient volumes over the next four to eight years because of a dearth of primary care physicians in the U.S., according to Rich Dallam, a partner at health care architectural firm NBBJ.

Lessons From Massachusetts?

Rep. Jim McDermott (D-Wash.) agreed that increased stress on EDs is a possibility. He pointed to Massachusetts, where a 2006 health law that created near-universal health coverage for state residents has failed to abate ED demand

 A recent American College of Emergency Physicians poll found that nearly two-thirds of Massachusetts residents said ED wait times have increased or remained the same since the law was enacted.

In addition, a report by the Council of State Governments released in February found that wait times had not declined since Massachusetts' law took effect.

CMS Response

CMS Chief Actuary Richard Foster also acknowledged that the primary care physician shortage could pose a challenge to EDs, but he noted that no one "has a very good handle on exactly how much of an infrastructure problem there will be or exactly how it might work out" (Heflin, The Hill, 5/15).