ER Misuse Causing Stress on Hospitals and Taxpayers

With Medicaid coverage expanding hospitals around the state, including Acadiana, are seeing a startling pattern: An increase in non- emergencies entering the ER. According to hospital administrators, one of the main reasons you see an increase is because there are few primary care physicians that accept Medicaid. But what these patients don’t realize is they’re costing taxpayers and the hospitals more money.

“Things that ER’s see a lot that would probably be best left to the general physician or an urgent care are STD tests, pregnancy tests, tooth aches, coughs, runny nose.” said Daryl Cetnar, System Director of Communications at Lafayette General Health.

Hospitals say one of the greatest causes in rising healthcare is the misuse of the ER.

“If you look over the past 6 months, out of all three of our Lafayette Emergency Departments we have seen 18,000 non-emergent emergency visits in our emergency department.”said Patrick Gandy, Executive Vice President of Lafayette General Health.

If you calculate those visits just from Lafayette General Health ER’s over the last two years, Cetnar said it equals to about 71,000 non-emergent Medicaid patients walking through the ER doors.

“Since Medicaid expansion we have seen a dramatic increase in the amount of non-emergent emergency room visits from that patient population. And that’s being driven by the lack of primary care services for that patient population in the state of Louisiana.” said Gandy.

Gandy and Cetnar said it costs more for the ER to treat a medicaid patient than it does at a Health Clinic or primary care physician accepting Medicaid. If those 71,000 patients went to a doctor’s office, the state would be saving more than 3,000,000 dollars.

“Those dollars that would be saving could be re-deployed to cuts other health care providers and services are seeing in the state of Louisiana.” said Gandy.

Gandy says a lot of times Medicaid patients think it could be faster to get treatment in the ER. But that isn’t the case as the ER bases emergency needs off of a triage system. For example, a car crash victim will be seen first since their condition is more severe than the condition of a runny nose.

“You can get great care in an ER but to be able to really focus on wellness and prevention that has to be done in a primary care setting that a primary care patient has a relationship with” said Gandy.

Now Cetnar and Gandy say the biggest problem for medicaid patients is not having a primary care doctor who accepts medicaid. Gandy said Lafayette General is trying very hard to help provide primary care appointments to patients with Medicaid.

The internal medicine clinic and family medicine clinics at UHC and the Medicaid Clinic at St. Martin Hospital see patients all day, Monday through Friday, and the new UHC urgent care clinic sees patients seven days a week, Monday – Friday, 5 – 9 p.m., and on the weekends from 7 a.m. – 3 p.m. This represents 156 hours per week of available scheduled or walk-in appointments for those with Medicaid. There is also a facility in Breaux Bridge that accepts medicaid.