Emergency Room Overutilization Essay -- Emergency Room Misuse

Emergency room over utilization is whiz of the leading causes of todays ever increasing health care cost. The mass of the patients seen in emergency rooms across the nation are Medicaid recipients, for non-emergent reasons. The national government initiated Medicaid Managed Care classs to offer better healthcare delivery, adequately doctor providers and reduce healthcare costs. Has Medicaid Managed Care addressed the issues and solved the problem? The service is Yes and No.Throughout the early 1980s and 1990s the Federal Medicaid program was challenged by rapidly rising Medicaid program costs and an increasing keep down of uninsured population. One of the primary reasons for the overall increase in healthcare costs is the over utilization of hospital emergency rooms. This is a count on result of not having a primary care physician and/or family doctor who is the main source of healthcare delivery for an individual and/or entire family The traditional Medicaid program does n ot offer, or require, recipients to choose a primary care physician like, its counterpart, Medicare. Medicare still operates under the traditional fee-for-service methodological abstract and does not require beneficiaries to identify and primary provider as wholesome as having direct access to specialty services. This allows a cost share-out approach which results in higher out-of-pocket expenses and does not cover medicine or prescription benefits.In an effort to offer better healthcare services and access as well as reduce costs the federal government allowed the States to turn to managed care and proposed a mandatory comprehensive implementation for the Medicaid population. In order to make major changes like these, states cook to request waivers of Medicaid regulatio... ...sive.(Practice Trends). Clinical Psychiatry News 33.2 (Feb 2005) 88(1). Academic OneFile. Thomson Gale. University of Phoenix. Retrieved February 25, 2013 from.5.Roohan, Patrick J., Anarella, Joseph P., & Gesten, Foster C. (July-August 2004) step oversight and improvement in Medicaid managed care.(Quality Assurance Reporting Requirements ). In ledger of Public Health Management and Practice, 10, p321(9). 6.Wang, Cheng, Villar, Maria Elena, Mulligan, Deborah A., & Hansen, Toran. (Nov 2005) Cost and utilization analysis of a Pediatric Emergency Department Diversion Project. In Pediatrics, 116, p1075(5). Retrieved July 11, 2013, from InfoTrac OneFile via Thomson Gale