Medicaid ‘Experiment’ Fails to Reduce Use of ED

A new study of the Oregon Health Insurance Experiment shows the program has fallen short on one of the key benefits promised—namely, that emergency room traffic would be reduced if state Medicaid rolls were opened up to low-income adults through a lottery system. Nearly 90,000 residents signed up for the lottery, but EDs are as crowded as ever. It’s beyond question that urgent care could reduce the congestion, but most Medicaid programs don’t offer urgent care-specific contracts or reimburse at a level that would allow the urgent care operator to realize a profit when treating Medicaid patients. Consequently, the ED remains the only on-demand option for patients covered by Medicaid. The study, conducted by Harvard University and the Massachusetts Institute of Technology and published in The New England Journal of Medicine, notes that ED use did not decline 2 years after new beneficiaries obtained coverage under the program.