Medi-Cal Patients Flocking To ERs More Than Before ACA

From California Healthline (hat tip: Dr. Menadue):

The architects and proponents of Obamacare had argued that once people got health coverage they would stop going to the ER so much, because they could visit primary care doctors instead. But in reality, people who were uninsured before the ACA were actually reluctant to go to the ER unless they were “about to die,” because they would be saddled with big bills, said state Sen. Richard Pan (D-Sacramento), a pediatrician. Under Medi-Cal, though, patients aren’t worried about those expenses.

And old habits die hard: A newly-insured patient accustomed to visiting the ER for treatment might not immediately switch to a primary care doctor who is, “just a name — not somebody you know,” Pan added.

Still, experts believe fewer Medi-Cal patients would be visiting the ER if there were more doctors willing to treat them.

Though “we have seen a very strong increase in the number of Medi-Cal patients … the number of doctors willing to see Medi-Cal patients has not increased accordingly,” said Jan Emerson-Shea, vice president of external affairs for the California Hospital Association.

Community Paramedic Program Success

From the Mail Tribune:

Data now in for 2016 shows the house calls program reduced emergency room costs by an estimated $448,100 and cut ambulance transport costs by an estimated $289,200 — for a total of $737,300.

With the $220,485 grant cost factored in, the program yielded estimated net savings of $516,815.

The patients in the program cut their overall emergency room use by 56 percent, surpassing Mercy Flights’ original goal of a 50 percent reduction.

Stewart says the program not only cut costs, but improved the patients’ overall health.

Meet the deadliest of the deadly opioids

From Axios:

Opioid overdose deaths have increased more than six-fold since the 1970s, and an estimated 2.5 million Americans abuse this class of drugs. But the deadliest killer is not heroin. Synthetic opioids, which can kill much faster than heroin, have fueled the epidemic. Here’s what they are:

  • “Grey death”: The newest street drug is a dangerous opioid cocktail that is 5,000 times as potent as heroin (CNN)
  • Carfentanil: This elephant tranquilizer is as powerful as “grey death” (National Affairs)
  • Fentanyl: The most commonly found synthetic opioid is 50 times as deadly as heroin (National Affairs)
  • Furanyl fentanyl: This version of fentanyl is 10 times as potent as heroin (USA Today)
  • U-47700: This research chemical, still legally available, is eight times as potent as heroin (NBC)

Cuts threaten rural hospitals ‘hanging on by their fingernails’

From CNN:

Nationwide, about 80 rural hospitals have closed since 2010, according to the Chartis Center for Rural Health. Another 673 rural hospitals are in danger of shutting their doors. Many providers worry that the newly proposed health care legislation — and in particular its proposed cuts to Medicaid — could push a number of hospitals over the edge.

“These hospitals are hanging on by their fingernails,” said Maggie Elehwany, vice president of government affairs for the National Rural Health Association, a nonprofit health research and advocacy group. “If you leave this legislation as is, it’s a death sentence for individuals in rural America.”