PPIC Releases Report on Emergency Department Utilization after ACA

The Public Policy Institute of California (PPIC) this week released a report examining health care coverage expansions under the Affordable Care Act (ACA) and their impact on the utilization of emergency department services. After controlling for factors such as patient age and health status, PPIC determined the odds of being a frequent emergency department user, defined as four or more annual emergency department visits, were significantly lower for Medi-Cal beneficiaries after the ACA. Among uninsured patients, the odds of frequent emergency department use declined event more.

However, the PPIC report found that, at the same time, there has been an overall increase in both the share and absolute number of emergency department patients who are frequent emergency department users, despite the lower odds of frequent emergency department use after the ACA. The largest predictors of frequent emergency department use—both before and after the ACA—were having a diagnosed mental health condition or substance use disorder. The PPIC findings suggest state efforts to better integrate physical and behavioral health services for Medi-Cal beneficiaries could help lower frequent emergency department visits. The full PPIC report is available here.