Non-Emergency ER Visits Are Costing Kentucky Taxpayers Millions

ER overcrowding is one thing, but unnecessary ER overuse is another. Just ask Kentucky, where last year alone, ER visits cost Kentucky residents $384 million in tax dollars strictly from Medicaid covered patients.

This would infuriate the most liberal minded taxpayer, and Kentucky is trying to be innovative in efforts to reduce this unnecessary expense. In a recent article published by WAVE 3 News, Eric Flack explored not only the problem of ER over and misuse, but what is being done to, for lack of better words, stop the bleeding.

Patients with Medicaid are said to be using the ER for a long list of non-emergency medical reasons including diaper rash, headaches, constipation, and ear aches - to name a few.

"ER is not where you deliver primary care," said Kentucky Medicaid Commissioner Stephen Miller when asked about this problem that is felt by taxpayers and overcrowded health systems.

According to WAVE 3 News, Kentucky’s Medicaid patients cost taxpayers a whopping $9.3 million by inappropriately visiting the ER almost 200,000 times in 2015. Believe it or not, reports claimed that one individual Medicaid patient visited the ER an unbelievable 382 times - which translates into a $71,000 - an ER medical tab left for taxpayers to pick up.

Governor Matt Bevin proposes that Medicaid patients pay a penalty of $75 every time they bring a non-ER problem to the ER, and an $8 admissions fee per ‘appropriate’ ER visits. It is safe to assume that this would deter most people from taking advantage of a system riddled with vulnerable spots, especially considering that ER doctors and nurses are obligated to provide services to anyone who is admitted.

But what if it’s not about being opportunistic, as opposed to simply being unaware of the Medicaid patient options that should be considered for less than major health concerns? This is exactly what doctors at Norton Healthcare believe is the root of the problem.

"Typically if someone is coming there it's often because they don't know where to go," said Chief Medical Officer for Norton Healthcare Dr. Steven Hester.

A recently launched Norton pilot plants social workers in hospitals to educate Medicaid patients on their medical options, pointing them in the right direction for their non-ER issues. This pilot saw a nearly 50 percent reduction in ER visits, but due to federal regulations obligating doctors and nurses to serve everyone that comes in the ER, regardless of the reason, it is ultimately up to the patient to make the right choice.