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Even Post-Reform, ER Visits in US Still High

06/30/16

  12:13:00 am, by MedBen5   , 259 words,  
Categories: News, Health Plan Management, Hospitals

Even Post-Reform, ER Visits in US Still High

emergency room

Despite the hope that an influx of new insureds through the Affordable Care would reduce the rate of emergency room (ER) visits, new data indicates that patients still seek care there at disproportionately high numbers. It highlights the need to offer benefits that promote ER visits for real emergencies, while encouraging those with less urgent needs to contact their family doctor first.

According to the Centers for Disease Control, in 2012 the ER visit rate in the United States was 42 visits per 100 persons, and about 20% of children and adults visited the ER at least once during the year. Private insurance was the most common form of payment, at 29%.

ER benefits can be tricky, as no health plan wants to discourage individuals from visiting an ER when the need is vital. But the relative convenience of the ER results in a large number of patients who could be better served by a primary care physician, ultimately costing the client much more for the same care. MedBen help clients to find the right benefits balance.

As with all aspects of plan design, MedBen works with clients to help them offer ER benefits that properly address employee population needs. Demographics, geography and claim history all factor into the plan design process, and MedBen is experienced in considering all of these elements.

Because every benefit affects care usage and costs, MedBen takes your plan design seriously. Learn more about how we do it by contacting Vice President of Sales & Marketing Brian Fargus at bfargus@medben.com.

Read more about the CDC study at Healthcare Dive.

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