“No pay” pays more than Medicaid

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Just when you thought that it couldn’t get any worse, the government is here to help. 

Uninsured patients have been getting a bad rap. Just as many presidential candidates are tuning up their plans for universal government health coverage, a new study is being released that suggests that patients with no insurance may pay more of their emergency room bills than some government insurance. In a study published in this months Annals of Emergency Medicine, researchers at UCSF were tracking the downward trend in reimbursements over the last eight years when they discovered that uninsured patients paid a larger percentage of their bill than patients with Medicaid. While the difference was not large–35% uninsured vs. 33% Medicaid–it came as a surprise and has implications for how EPs might look at the prospects of the increased compensation under a government-run insurance program.
The study looked at over 43,000 emergency department patient visits from 1996 to 2004. It demonstrated that reimbursement overall has fallen from 57 to 42 percent. Patients with private insurers paid the highest percentage of their bills but have declined the most. Payment from the uninsured has remained somewhat stable. Patients who are insured by Medicaid now pay the smallest fraction of their bill. The House Committee on Oversight and Government Reform is currently considering further cuts to Medicaid.

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