Increase in ER Visits Due to ACA Exacerbates Physician Workforce Issues

Nearly half of emergency physicians responding to a poll are already seeing a rise in emergency visits since January 1 when expected coverage under the Affordable Care Act (ACA) began to take effect. In an online poll conducted by the American College of Emergency Physicians (ACEP), 86 percent are expecting emergency visits to increase within the next three years.

The data suggests that states with expanded Medicaid coverage are more likely to see increases in the volume of Medicaid emergency patients. “Long-term solutions, such as increasing the supply of primary care physicians, will take years to develop and would not solve our immediate, short- term policies,” said Alexander Rosenau, DO, FACEP, president of ACEP and past president of the Pennsylvania Chapter of the American College of Emergency Physicians (PaACEP).

An overwhelming 84 percent of emergency physicians reported that psychiatric patients are being held in their emergency departments. “Those having a mental health crisis seek care in emergency rooms because other parts of the health care system have failed them,” said Dr. Rosenau. “Because of the critical shortage of mental health resources, some of these vulnerable patients wait for days in emergency departments. It is simply inhumane.”

The more than 200 physicians attending the 2013 PAMED annual House of Delegates meeting voted to address the issue by endorsing the development of a voluntary shared bed tracking system for behavioral health and detoxification beds across the state.

When asked about the most important policy solution to improve emergency care, 32 percent responded “enacting liability reform.”

“The lack of medical liability limits is directly correlated to workforce shortages in medicine, especially among specialists called to see patients in the emergency department,” said Dr. Rosenau.