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Editor's Note |

Triage, Copayments, and Emergency Department Visits

Joseph S. Ross, MD, MHS
JAMA Intern Med. 2016;176(6):854-855. doi:10.1001/jamainternmed.2016.0882.
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Use of the emergency department (ED) for nonurgent care is frequent and costly. These costs are of particular concern to state Medicaid programs, whose beneficiaries generally experience diminished access to primary care and may be more likely to rely on the ED for nonurgent care. The Deficit Reduction Act of 2005 gave state Medicaid programs the authority to impose cost-sharing strategies on certain services, including copayments for nonurgent visits to the ED. While copayments have been shown to broadly reduce use of the ED,1 recent evidence suggests that allowing states to impose copayments for nonurgent visits did not impact ED use among Medicaid beneficiaries.2 However, these copayments are still likely to have an effect on the financial lives of Medicaid beneficiaries and other individuals whose insurance plans have adopted similar policies.


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