Emergency room physicians say more of the patients they see have delayed seeking medical care despite having health insurance, because of high out-of-pocket expenses, high deductibles or high co-insurance.
In addition, increasing numbers of Medicaid patients are postponing medical care, the doctors say, because of health plans that don’t provide adequate numbers of primary care physicians. The ER doctors say the trend to “narrow networks,” with fewer providers, is growing as health plans try to hold down costs.
In a poll conducted by the American College of Emergency Physicians (ACEP), seven in 10 ER physicians said they are seeing an increase in the number of patients with health insurance who have delayed seeking medical care. A slightly higher percentage (73%) said the same is true of Medicaid patients.
About two-thirds (67%) of the doctors reported that primary care physicians are sending patients to emergency departments to receive medical tests or procedures when health insurance companies refuse to cover them in an office setting.
“This is a scary environment for patients,” said Jay Kaplan, MD, president of ACEP. “Many patients are motivated by fear of costs and not by the seriousness of their medical conditions.”
Dr. Kaplan said insurance companies are shifting costs to patients and medical providers to improve their profits. “In addition, health insurance companies are shrinking the number of doctors available in their networks, making it more likely that patients will be forced into out-of-network situations,” he said.
In other findings from the poll, 65% of doctors say they are seeing more patients coming to emergency rooms; 60% reported having difficulty finding specialists for their patients because of plans with limited numbers of medical providers; and 20% are considering opting out of health insurance networks because of low payments by health plans.
The poll was conducted by the American College of Emergency Physicians, a national medical specialty society representing emergency medicine, in September 2015, with 1,433 emergency physicians responding. The margin of error is 2.6%. The full survey is available online.