Researchers at Harvard Medical School Target Managed Care (Is the Emergency Department Used As a Substitute or a Complement To Primary Care In Medicaid?): Managed Care

2023 NOV 28 (NewsRx) -- By a News Reporter-Staff News Editor at Insurance Daily News -- Investigators discuss new findings in Managed Care. According to news originating from Boston, Massachusetts, by NewsRx correspondents, research stated, “Policies to decrease low-acuity emergency department (ED) use have traditionally assumed that EDs are a substitute for unavailable primary care (PC). However, such policies can exacerbate ED overcrowding, rather than ameliorate it, if patients use EDs to complement, rather than substitute, their PC use.”

Our news journalists obtained a quote from the research from Harvard Medical School, “We tested whether Medicaid managed care enrolees visit the ED for nonemergent and PC treatable conditions to substitute for or to complement PC. Based on consumer choice theory, we modelled county-level monthly ED visit rate as a function of PC supply and used 2012-2015 New York Statewide Planning and Research Cooperative System (SPARCS) outpatient data and non-linear least squares method to test substitution vs complementarity. In the post-Medicaid expansion period (2014-2015), ED and PC are substitutes state-wide, but are complements in highly urban and poorer counties during nights and weekends. There is no evidence of complementarity before the expansion (2012-2013). Analyses by PC provider demonstrate that the relationship between ED and PC differs depending on whether PC is provided by physicians or advanced practice providers. Policies to reduce low-acuity ED use via improved PC access in Medicaid are likely to be most effective if they focus on increasing actual appointment availability, ideally by physicians, in areas with low PC provider supply.”

According to the news editors, the research concluded: “Different aspects of PC access may be differently related to low-acuity ED use.”

This research has been peer-reviewed.

For more information on this research see: Is the Emergency Department Used As a Substitute or a Complement To Primary Care In Medicaid? Health Economics, Policy and Law, 2023:1-19. Health Economics, Policy and Law can be contacted at: Cambridge Univ Press, Edinburgh Bldg, Shaftesbury Rd, CB2 8RU Cambridge, England. (Cambridge University Press - www.cambridge.org; Health Economics, Policy and Law - http://journals.cambridge.org/action/displayJournal?jid=HEP)

The news correspondents report that additional information may be obtained from Alina Denham, Harvard Medical School, Dept. of Health Care Policy, 180 Longwood Ave, Boston, MA 02115, United States. Additional authors for this research include Elaine L. Hill, Michael Mendoza, Peter J. Veazie, Maria Raven and Mical Raz.

The direct object identifier (DOI) for that additional information is: https://doi.org/10.1017/s1744133123000270. This DOI is a link to an online electronic document that is either free or for purchase, and can be your direct source for a journal article and its citation.

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