Medically unnecessary ambulance rides soar after ACA expansion

medicalxpress.com ^ | June 28, 2019 | University of Colorado Denver

[BenLurkin]

By 2016, two years into the expansion of the Affordable Care Act (ACA), 17.6 million previously uninsured people around the U.S. had gained health insurance coverage. But with the expansion, researchers at the University of Colorado Denver and the University of Kentucky found that ambulance dispatches for minor injuries like abrasions, minor burns and muscle sprains rose by a staggering 37% in New York City.

The authors analyzed data from all of the 911 ambulance dispatches in New York City between January 1, 2013, and July 31, 2016. In New York City, 911 calls are routed through a central dispatch to a trained EMS dispatcher, who triages the call based on type and severity of injury, alerting ambulances in one of the city's 31 zones.

In the years before and after the ACA, dispatches to more severe injuries (such as chest pain, compound fractures and unconsciousness) remained relatively the same. But dispatches to minor injuries leapt 37.2%, from an average of 20.75 dispatches per dispatch zone per month before ACA to 28.46 in the years following. The increase is equivalent to approximately 239 additional dispatches a month—or 2,868 per year—for minor injuries.

Previous research found that when Uber shows up in a city, the usage of ambulance services drop off. With the expansion of the ACA, the out-of-pocket cost of ambulances tumbled for many people. When patients bear a smaller portion of the cost, researchers argue, they will be more likely to use an ambulance for medical transportation in less emergent situations.

As a result, the medically unnecessary rides may add to city congestion, slow response time to actual emergencies and increase the risk of death for those in dire situations.

[GnuThere]

I ended up in an ambulance once after a fall and they did all kinds of unnecessary things to boost the charges - neck brace, oxygen, IV, etc, like a full-blown trauma patient. In retrospect I should have insisted on a cab.

[steve86]

“Din du nothins”

No one talks like that around here and — surprise — the cities are not experiencing problems with ambulances used as taxis.

[TauntedTiger]

Too funny. My insurance paid 1k for each time the ambulance past the Deputy Chief’s home. (Deputy Chief is one of my neighbors.) In fact, if the guy who found me had put me in his car we would have been in ER five to ten minutes sooner. Slowest ride to ER I could have imagined. Literally at the peak of human pain and I’m wondering what route they are taking? The expensive route.