Hospitals Brace for More ER Visits Due to Health Care Reform

Updated: 10/21/2013 8:02 AM By: Naomi Pescovitz

The Affordable Care Act is supposed to help alleviate pressure on crowded emergency departments by giving people better access to preventative care and their regular doctors. That may not be the case.

In our 5 EYEWITNESS News series, "ER Emergency," we explain how the Affordable Care Act could impact already busy emergency departments. Our series also investigates a national and statewide shortage of doctors. Finally, we will describe the many solutions underway at local hospitals and clinics.

Busy Departments

"I think you can say nothing is typical at Hennepin," said Dr. William Heegaard, Assistant Chief of Emergency Medicine at Hennepin County Medical Center.

In the heart of the Emergency Department at HCMC, six different patients fill a fast hour on the floor.

"Emergency medicine is really a specialty with a room with a view," Heegaard said.

Each room delivers a new case, from food borne illnesses to fevers, head injuries or trauma.

"Right now we are busy; all of the main beds in the emergency department are full and we have people waiting to be seen," Heegaard said during an afternoon interview in the ER. The department has about 60 main beds.

Heegaard has been at HCMC for nearly two decades. He is also President of the Minnesota American College of Emergency Physicians. His job is in demand now more than ever.

"We have seen a significant increase over time in the number of people that have been using emergency services," Heegaard said.

According to the American Hospital Association, there were 88.5 million emergency department visits nationwide 1991. That number shot to nearly 130 million by 2010, according to the Centers for Disease Control and Prevention.

Squeezed from Both Ends

According to an American Hospital Association, there were 5,108 emergency departments in 1991. The latest survey shows there are now nearly 650 less nationwide and 14 less in Minnesota.

"So you have a compressed number of emergency departments, an expanding pool of individuals; we've just seen our volumes go up and up and up," Heegaard said.

Will Health Care Reform Fix It?

"You have to have a lot of patience to wait," one Minneapolis woman said outside of HCMC. She said she had been to the emergency department 10 times or more in the past five years for a heart condition.

She has insurance, so we asked why she chooses the ER over her primary care doctor.

"I'm on a limited income; I can't afford that. If I had money, I could. You know when you have money, I could have my eyes corrected, and all that," she said.

Under the Affordable Care Act, 300,000 to 400,000 uninsured Minnesotans could now be covered. The health care system is also facing a growing number of older Americans.

Instead of taking a step back, hospitals are bracing for more.

"I think for emergency medicine, we're going to see an increase, maybe 7 percent, overall. And it's too early to know how long that will last," Heegaard said.

The best case study for health care reform is in Massachusetts, where universal health care was enacted in 2006. According to state data, emergency room visits increased 6 percent from 2006 to 2010. Minnesota hospitals are weeks from knowing what will happen here.

"There is going to be an increased demand. We think that that will probably level off. But I can assure you, places like Hennepin are going to be under higher demand. Higher demand for services, and we also know that financially, it's more challenging for public hospitals," Heegaard said.

Click here to check out recent studies on emergency care and ER visits. You can also check local wait times at your closest hospital and see how the Massachusetts' health care law impacted residents there.