Racial and Ethnic Differences in Insurer Classification of Nonemergent Pediatric Emergency Department Visits.

ABSTRACT:

Importance

Government and commercial health insurers have recently enacted policies to discourage nonemergent emergency department (ED) visits by reducing or denying claims for such visits using retrospective claims algorithms. Low-income Black and Hispanic pediatric patients often experience worse access to primary care services necessary for preventing some ED visits, raising concerns about the uneven impact of these policies.

Objective

To estimate potential racial and ethnic disparities in outcomes of Medicaid policies for reducing ED professional reimbursement based on a retrospective diagnosis-based claims algorithm.

Design, setting, and participants

This simulation study used a retrospective cohort of pediatric ED visits (aged 0-18 years) for Medicaid-insured ch

SUBMITTER: Pomerantz A 

PROVIDER: S-EPMC10160869 | biostudies-literature | 2023 May

REPOSITORIES: biostudies-literature