Four in 10 emergency department visits are billed to public insurance
Research Activities, October 2009
More than 40 percent of the 120 million visits that Americans made to hospital emergency departments (EDs) in 2006 were billed to public insurance, according to the Agency for Healthcare Research and Quality. About 50 million ED visits were billed to Medicaid and Medicare. The uninsured accounted for another 18 percent of visits for emergency care, while 34 percent were billed to private insurance companies. The rest were billed to workers' compensation, military health plan administrator Tricare, and other payers.
The Agency's study of hospital ED use in 2006 also found that:
- About 38 percent of the 24.2 million visits billed to Medicare ended with the patients being admitted, compared with 11 percent of the 41.5 million visits billed to private insurers, 9.5 percent of the 26 million visits billed to Medicaid, and 7 percent of the 21.2 million visits by the uninsured.
- The uninsured were the most frequent users of hospital EDs. Their rate was 1.2 times greater than that of people with public or private insurance—452 visits per 1,000 people vs. 367 visits per 1,000 people, respectively.
- The uninsured were also the most likely to be treated and released—a possible indication of their use of hospital EDs as their usual source of care. Their "treat-and-release" rate was 421 visits per 1,000 people vs. 301 per 1,000 people for the insured.
These findings are based on data in HCUP Statistical Brief #77, Payers of Emergency Department Care, 2006 (http://www.hcup-us.ahrq.gov/reports/statbriefs/sb77.jsp).
The report uses statistics from the 2006 Nationwide Emergency Department Sample, a new AHRQ database that is nationally representative of ED visits in all non-Federal hospitals. The Nationwide Emergency Department Sample (http://www.hcup-us.ahrq.gov/nedsoverview.jsp) contains 26 million records from ED visits from approximately 1,000 community hospitals nationwide. This represents 20 percent of all U.S. hospital EDs.