PRI report: Recommendations to lower Medicaid ED use

Friday, the legislative Program Review and Investigations Committee released results of their study on Medicaid ED use finding that while per capita Medicaid members’ use of the ED fell slightly between 2010 and 2012, Medicaid still makes up the largest source of ED users in CT at 36%. Despite the per capita decrease, Medicaid members are three times more likely to visit an ED than the average CT resident. The report considers alternatives to the ED including expanding access to alternative care including improving Medicaid provider participation, increased primary care payment rates under the ACA, and patient-centered medical homes. The report makes several recommendations to reduce Medicaid clients’ reliance on EDs including patient education about alternatives, linking people to providers, secret shopper surveys to accurately assess capacity, continuous eligibility, telemedicine to improve access to specialty care and better coordination with behavioral health programs.