Out-of-Network Emergency Department Use among Managed Medicaid Beneficiaries.

ABSTRACT:

Objective

Out-of-network emergency department (ED) use, or use that occurs outside the contracted network, may lead to increased care fragmentation and cost. We examined factors associated with out-of-network ED use among Medicaid beneficiaries.

Data sources and study setting

Enrollment, claims, and encounter data for adult Medi-Cal health plan members with 1+ ED visits and complete Medicaid eligibility during the study period from 2013 to 2014.

Study design

We analyzed the data to identify factors associated with out-of-network ED use classified by mode of arrival (ambulance vs. nonambulance).

Data extraction methods

We extracted encounter, ambulance, and ED census data and linked them together based on ED visit date.

Principal findings

Of 11,143 ED vis

SUBMITTER: Raven MC 

PROVIDER: S-EPMC5682123 | biostudies-literature | 2017 Dec

REPOSITORIES: biostudies-literature