More spending on initial ED visit may lower total Medicare cost, study finds

Total costs to Medicare may be lower when more is spent on care in the emergency department, according to a new study published in JAMA Network Open.

“Our results suggest that the focus on rising ED utilization and costs may fail to capture the full costs associated with an acute episode and the role that ED care plays in moderating these costs,” the authors said. 

For the study, researchers wanted to see if total 30-day and 90-day costs of care changed over time for Medicare patients who received ED care. The cross-sectional study concerned more than 14 million visits at nearly 4,750 EDs from 2011-16. The study included a 20 percent national sample of Medicare patients.

Researchers found 30-day and 90-day costs of care for Medicare patients fell during the study period. The trend was associated with lower use of inpatient care when the patient first presented to the ED as well as lower use of inpatient and post-acute care afterward.

“These findings suggest that the increase in spending on outpatient ED care may be associated with lower total Medicare spending,” according to the authors. 

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