Diverting Costly Emergency Room Visits to Health Centers

Hospital emergency rooms (ERs) are a vital part of America’s health care system. They respond to acute illnesses and injuries 24 hours a day, seven days a week. Federal law requires almost all emergency rooms to examine and, if necessary, stabilize everyone who seeks care, regardless of their ability to pay, perceived need or immigration status. Inadequate access to primary or preventive care, uncontrolled chronic conditions such as asthma or diabetes, and lack of insurance are some reasons patients seek non-emergency care at ERs. The problem with a non-emergency visit to an emergency room is that it can cost up to seven times more than a visit to a health center.

A 2008 study by the Centers for Disease Control and Prevention found that those who had no insurance sought medical care in emergency departments at more than twice the rate of those with private insurance. According to the Institute of Medicine, Medicaid patients have higher rates of emergency department use compared to patients with other sources of payment. Therefore, states often end up paying for emergency room visits through Medicaid or other state coverage programs.