How primary care practice affects Medicaid patients' use of emergency services

The use of emergency departments (EDs) in the U.S. continues to rise. Some of these ED visits may reflect limited access to primary care, even among patients with a primary care provider. Payers and policymakers have tried to restrain ED use, because of concern over high charges and discontinuity of care. But most of these attempts have involved erecting financial and administrative barriers to going to the ED, rather than expanding access to primary care. Is it possible to reduce excessive use of EDs by making primary care practices more "user-friendly"? This Issue Brief summarizes research that identifies primary care characteristics associated with ED use in a Medicaid managed care population. It suggests a strategy to simultaneously improve access to primary care and reduce costs of ED care.