ER visits spike due to Affordable Care Act

[Birdstrike]

(Oh and before anyone gets all butt-hurt, I'm not saying ...

Are your trying to suppress our constitutional right to "get all butt-hurt"?

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[Old_Mil]

Certainly some places may be impacted more than others. I'm just curious about any net increases at a state, or more preferably, a national level.)

Well, there will be a disparate impact. A place that has a poor payor mix and a low number of clinic physicians per capita is going to see emergency departments hurt worse than a place with a good payor mix and a high number of clinic physicians because a percentage of medicaid patients will try and use a clinic if it is available to them.

This (http://www.beckershospitalreview.com/finance/americas-payor-mix-by-region.html) splits payor mix by region but that isn't really detailed enough. Your city might have a good manufacturing base and a high number of privately insured patients and one on the other side of the state might not. I discovered a hospital in a non medicaid expansion state whose medicaid population is only 9%, significantly below the national average. They have seen no spike in visits over the same period ours rose 29%. If I was going to stay, I would probably take this job.

The bottom line, though, is that when you are practicing in a medicaid expansion state with a poor payor mix you're the only guy in town who can't stop an unlimited number of them from coming through your front door.