As of October 1st, the State of Washington has decided to "save money" on Medicaid (DSHS) medical care payments, by allowing maximum of three “non-emergency” visits to emergency departments each year. They have drawn up a list of more than 700 diagnoses as “non-emergent” that include such surprising symptoms as chest pain, abdominal pain, miscarriage and breathing problems, and the decision affects all Medicaid patients, including children.
Now all of us want to save money on rising health care costs, and if some is wasted in the emergency department, it makes good sense to try and reduce the waste, but this plan is ridiculous! People who go to the emergency department often do so because they have no regular physician or other alternative and they do not know where else to go. The "savings" the state thinks they will get will actually be a cost to the hospital who is not paid, and that will simply drive up costs for the rest of us. Limiting access to people in pain, having trouble breathing or having a miscarriage, without providing an alternative, is dangerous, unethical and wrong.
The Washington State state chapter of the American College of Emergency Physicians (WA-ACEP) has filed suit to void this action by our state Health Care Authority. Their action follows an unsatisfactory effort to work with the Health Care Authority before filing suit.
Any effort to save money in medical care must also address patient safety, effectiveness, timeliness, efficiency, equity and the needs of the patient. This action by the State of Washington fails on all levels!