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Wisconsin Leads the Nation in Post-ACA Non-Emergency ER Visits

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The Affordable Care Act was supposed to get newly insured patients out of emergency rooms and into primary care doctors’ offices. But since the ACA went into effect, ER visits have spiked, and Wisconsin is leading the nation in non-emergency visits to the emergency room.

Why are so many patients who now have insurance still taking their aches a sprains to the ER?

Robert Blendon is a Professor of Health Policy and Political Analysis at Harvard's School of Public Health. It – along with the Robert Wood Johnson Foundation and NPR -- releaseda study on patient perspectives on healthcare. He says many people end up in the emergency room for minor health concerns because they don't have anywhere else to go.

"In many communities, people in medical practice are not open on weekends, they’re not open on nights, and so patients who feel they really needed to be seen at odd hours use those emergency rooms," Blendon says.

But that happens everywhere. So why are so many of Wisconsin’s emergency room patients being treated for things that could be handled in a doctor’s office – 51-percent when the national average is 47? Blendon says Wisconsin just doesn’t have enough primary care doctors, clinics, or urgent care facilities to serve the number of newly insured patients.

"So, what is available where they live is emergency rooms. So you’ve given them a card, but the physicians haven’t moved into central Milwaukee. They haven’t moved into the more difficult, isolated, rural areas. So people use that card to go to the only facility that may be just available for them."

Dr. Chris Decker is in the thick of this increase in emergency room patients. He’s the Emergency Department Medical Director at Froedtert & the Medical College of Wisconsin. He says it’ll be awhile before things slow down in Wisconsin’s emergency rooms.

"Some of this may be as simple as education," Decker says. "Some of it is meeting patient’s needs, having off-hours clinics or after hours clinics or weekend clinics. We’re having that dialogue at this institution. I know they’re having the dialogue citywide. But that kind of dialogue is occurring because of the increased volumes that we’re seeing because of the ACA."

Blendon says Wisconsin’s health care industry will eventually have room for all of its new patients, but it could take five years before there is a significant drop in the percentage who use emergency rooms for non-emergency care.

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