Medicare patients are getting sicker and are visiting the emergency department more often, according to an American Hospital Association issue brief.
The brief, "Sicker, More Complex Patients are Driving up Intensity of ED Care," is based on an analysis of Medicare claims data conducted by The Moran Company. The data show as Medicare patients grow sicker and visit the ED more, the intensity of ED services required also increases.
Here are some key findings on Medicare fee-for-service patients for the period 2006 to 2010:
Medicare patients are getting sicker
• The average severity of illness for Medicare FFS ED patients increased 9 percent.
More Medicare patients are visiting the ED, and are visiting more often
• The average number of ED visits per 1,000 beneficiaries increased nearly 12 percent.
• The percent of beneficiaries with three or more visits in one year increased from 13.5 to 15.5 percent.
EDs are providing higher intensity services to Medicare patients
• The number of ED visits by Medicare patients that included outpatient observation services, which are higher intensity services, increased 72 percent. This trend is driven largely by an increased scrutiny of patient admissions and pressure to shift care to the outpatient setting, according to the issue brief.
• The number of ED visits by dual-eligible beneficiaries — who are among the sickest and poorest Medicare patients — increased, which contributed to the increase in higher intensity ED services among beneficiaries.
• The number of ED visits by Medicare patients which a behavioral health diagnosis, which often requires more intense care, increased nearly 50 percent.
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The brief, "Sicker, More Complex Patients are Driving up Intensity of ED Care," is based on an analysis of Medicare claims data conducted by The Moran Company. The data show as Medicare patients grow sicker and visit the ED more, the intensity of ED services required also increases.
Here are some key findings on Medicare fee-for-service patients for the period 2006 to 2010:
Medicare patients are getting sicker
• The average severity of illness for Medicare FFS ED patients increased 9 percent.
More Medicare patients are visiting the ED, and are visiting more often
• The average number of ED visits per 1,000 beneficiaries increased nearly 12 percent.
• The percent of beneficiaries with three or more visits in one year increased from 13.5 to 15.5 percent.
EDs are providing higher intensity services to Medicare patients
• The number of ED visits by Medicare patients that included outpatient observation services, which are higher intensity services, increased 72 percent. This trend is driven largely by an increased scrutiny of patient admissions and pressure to shift care to the outpatient setting, according to the issue brief.
• The number of ED visits by dual-eligible beneficiaries — who are among the sickest and poorest Medicare patients — increased, which contributed to the increase in higher intensity ED services among beneficiaries.
• The number of ED visits by Medicare patients which a behavioral health diagnosis, which often requires more intense care, increased nearly 50 percent.
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