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GAO-11-414R 1 (2011-04-11)

handle is hein.gao/gaobaanxk0001 and id is 1 raw text is: i G AO Acountabiity I Integrity * Reliability United States Government Accountability Office Washington, DC 20548 April 11, 2011 The Honorable Tom Harkin Chairman Committee on Health, Education, Labor, and Pensions United States Senate The Honorable Bernard Sanders Chairman Subcommittee on Primary Health and Aging Committee on Health, Education, Labor, and Pensions United States Senate Subject: Hospital Emergency Departments: Health Center Strategies That May Help Reduce Their Use Hospital emergency departments are a major component of the nation's health care safety net as they are open 24 hours a day, 7 days a week, and generally are required to medically screen all people regardless of ability to pay.' From 1997 through 2007, U.S. emergency department per capita use increased 11 percent.2 In 2007, there were approximately 117 million visits to emergency departments; of these visits, approximately 8 percent were classified as nonurgent. The use of emergency departments, including use for nonurgent conditions, may increase as more people obtain health insurance coverage as the provisions of the Patient Protection and Affordable Care Act (PPACA) are implemented.3 'In order to participate in Medicare, hospitals are required to provide a medical screening examination to any person who comes to the emergency department and requests an examination or treatment for a medical condition, regardless of the individual's ability to pay. Social Security Act §§ 1866(a)(1)(1), 1867 (codified at 42 U.S.C. §§ 1395cc(a)(1)(I), 1395dd). Medicare is the federal health program that covers seniors aged 65 and older, certain disabled persons, and individuals with end-stage renal disease. 2In 1997, there were an estimated 35.6 emergency department visits per 100 people compared to 39.4 visits in 2007. See P. Nourjah, National Hospital Ambulatory Medical Care Survey: 1997 Emergency Department Summary, Advance Data, no. 304 (1999), and R. Niska, F. Bhuiya, and J. Xu, National Hospital Ambulatory Medical Care Survey: 2007 Emergency Department Summary, National Health Statistics Reports, no. 26 (2010). 3For purposes of this report, we refer to the Patient Protection and Affordable Care Act, Pub. L. No. 111-148, 124 Stat. 119, as amended by the Health Care and Education Reconciliation Act of 2010, Pub. L. No. 111-152, 124 Stat 1029, as PPACA According to estimates from the Congressional Budget Office (CBO), an additional 32 million individuals are projected to obtain health insurance coverage by 2019; CBO also estimates that gaining insurance increases an individual's demand for health care services by about 40 percent. See D. Elmendorf, Director, CBO, Economic Effects of the March Health Legislation (presentation at the Leonard D. Schaeffer Center for Health Policy and Economics, University of Southern California, Los Angeles, Calif., Oct. 22, 2010). GAO-11-414R Health Center Strategies

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