Study finds most ER visits by Medicaid recipients are urgent

There’s concern nationwide that patients seeking routine care are using more expensive emergency rooms. A new study of Medicaid patients shows most go to the ER for urgent or serious ailments.

In an op-ed piece last year, Wisconsin Health Services Secretary Dennis Smith said Medicaid costs were in part being driven up by what are called “frequent flyers”: a small number of patients who often go to the ER for standard care they could get elswhere.

According to the national Center for Studying Health System Change, all Medicaid patients — not just frequent flyers — have a higher rate of ER use than privately insured individuals. But the study says the reason they’re in the ER is because they need to be: three-quarters of the Medicaid visits were determined to be urgent or semi-urgent. Local data says 46 percent of Milwaukee County ER use could be diverted; most of that is Medicaid patients, but it also includes those covered by private insurance and the uninsured, says Joy Tapper. She’s executive director of the Milwaukee Health Care Partnership. “This is not to blame patients, because because they’re making the best choices they can. Its really about education, redirecting, and we believe the care philosopy is connecting people with primary care.”

The partnership is doing that by scheduling appointments for people at Milwaukee’s federally funded clinics after they get routine care at the ER. Tapper says on average, 600 patients a month are being diverted to more appropriate and cheaper care settings.