Since Obamacare, L.A. County ER visits show hospitals in 'state of flux'

A key measure of hospital emergency room use in Los Angeles County shows continued growth during the first six months of Obamacare, but also points to shifting patterns of where patients are choosing to receive urgent medical treatment.

With the healthcare expansion last year, many are watching how the Affordable Care Act affects emergency room use.

President Obama has promised his signature health law will gradually reduce expensive ER visits as access to other kinds of care is expanded. Critics contend newly insured patients especially those enrolled in Medi-Cal, the state's low-income health program that picks up most patient costs aren't likely to seek care elsewhere, and will overwhelm emergency rooms.

Neither of those outcomes were clearly evident in the first months of the new healthcare system's operation in Los Angeles County, according to a Los Angeles Times analysis.

Data hospitals report to the state show that as insurance coverage was extended to hundreds of thousands of residents, ER visits for ailments not serious enough to require an admission grew 3.9% in the county in the first half of 2014, compared with the same period the previous year. The growth is in line with annual increases of 3% to 5% in the three years prior to the federal healthcare overhaul.

Despite little rise in overall emergency room use, the analysis found some significant changes in the distribution of those outpatient ER visits.

The county's three large public hospitals, which historically have cared for many uninsured patients, recorded a 9% drop in such cases. At the same time, several private hospitals reported double-digit percentage increases in outpatient visits, the analysis found.

What the uneven and changing usage patterns mean and whether they signal the beginning of a long-term rearrangement of how patients will seek treatment is not yet clear.

Shannon McConville, a health policy researcher at the Public Policy Institute of California, said the slight growth in visits not leading to an admission generally considered less serious cases that include those that Obamacare aims to divert away from emergency rooms was "good news."

In addition, several private hospitals said they have, at least for now, been able to handle increases in ER patient visits.

More here:
Since Obamacare, L.A. County ER visits show hospitals in 'state of flux'