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Emergency Room Visits

Dec
13

Date: December 13th, 2013

Patients Need To Have Concrete Reasons for EmergenciesIt was hard to figure out if the healthcare system in the United States would dip any further, until now that citizens can start seeing some positivity in it. It is not a huge improvement though and hence it is not a reason to give the system a clean bill of health. Many of you will wonder what the change is to have some positive talk about this system that has fallen out with many US citizens. The goodness about the system is to do with the resent Washington State Medicaid decision blocking payment for emergencies that their beneficiaries incur without serious cases that require emergency attention. Medicaid cannot foot the bills for such patients anymore, and that is the only wise move that can be commended so far.

The Decision in Figures

Almost every public healthcare insurer and Medicaid in the state of Washington is running out of cash. In the financial year 2011-2013, the state is faced with a budget of 1.4 billion dollars. This has led the state to start reducing the cost of funds offered to the Medicaid beneficiaries. So far, the decision has started with removing the basic plan that provides healthcare to 35,000 low-income earners. Dental care has also been affected by this decision because people with developmental disabilities will not be enjoying the routine checks. The level of care for personal care services will be increased. Some other services that have been eliminated are the interpreter services and Adult Day Health program. These decisions do not go along with the recent innovation that is meant to save of Medicaid expenses in the emergency rooms. The new plan will be a test run as no other state has ever tried it.

Reality in It

In reality, some of the Medicaid beneficiaries in Washington State are stretching the meaning of aid too far. This gives the authorities the green light to forge on with their decision to pay the bills for serious cases that call for the services of the emergency rooms. The chief medical officer for the Medicaid program Dr. Jeff Thomson agreed that the state would only pay for the necessary care that will be medically accepted. He said that some patients bypass the ability of the primary care and go for the ERs, which is needlessly expensive. Currently, the use of the ERs is out of control and calculations show that the trend costs the government 21 million dollars a year. Many patients make regular visits that can go up to 120 times a year, costing the government about $25,000 per patient. Most of the doctors in the ERs do not have a reason to send them away because after all the bills are paid by the state.

To understand how ERs work, it is good to know that no patient is supposed to be blocked from using the services, regardless of whether he or she is paying or not. However, the beneficiaries of Medicaid are misusing the rules.

 

 

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