Sicker Medicare patients requiring more complex care are driving up the intensity of ED care, according to a report by the American Hospital Association.
Recent data indicate the number of ED services provided to Medicare beneficiaries is growing, and patients needs are shifting toward services that demand the use of more resources, according to the report.
Policymakers have noted an upward shift in the intensity of care provided to Medicare beneficiaries in hospital EDs, and have raised concerns that the trend is leading to higher spending. Between 2006 and 2010, the severity of illness of beneficiaries receiving services in the ED increased, as did the rate of use.
The report, based on an analysis of Medicare claims data conducted by The Moran Company, outlines a number of factors that are contributing to this trend:
• Medicare beneficiaries receiving ED care are sicker than they used to be upon arrival.
• The rate of use of ED services by Medicare beneficiaries is rising.
• Patient care is shifting from the inpatient hospital to the ED.
• Use of the ED by dual-eligible patients (those who qualify for both Medicare and Medicaid) is rising.
• EDs are serving more Medicare patients with behavioral health diagnoses.
“The reality is that seniors who come to the hospital ED are sicker and have more chronic illnesses,” AHA President and CEO Rich Umbdenstock said in a news release. “Hospitals are striving to meet their communities needs, which means caring for patients who need more — and more intensive — services than ever before.”
Download a PDF of the report: “Sicker, More Complex Patients are Driving up Intensity of ED Care,” available at www.aha.org/research/policy/2013.shtml.