Emergency Departments, Medicaid Costs, and Access to Primary Care — Understanding the Link

Published in: The New England Journal of Medicine, v. 366, no. 23, June 2012, p. 2141-2143

Posted on RAND.org on January 01, 2012

by Arthur L. Kellermann, Robin M. Weinick

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Attempts by states to save money by seeking to lock Medicaid enrollees out of the emergency department are likely to backfire. We take the recent example of Washington state, where a proposed change in reimbursements for emergency department care for patients covered under Medicaid would have paved the way to retroactive denials—a very troubling policy that could stick the poorest patients with bills they cannot afford to pay. We argue that a better solution is to reverse what for many years has been a trend of shrinking access to primary care for Medicaid beneficiaries.

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