05/29/2015

Reps. Butler, Johnson, Introduce Healthcare Revisions

House Bill 157, sponsored by Reps. Jim Butler (R – Oakwood) and Terry Johnson (R – McDermott), would make a variety of revisions to healthcare laws. Some of the bill’s provisions are supported by Ohio ACEP. There is, however, a provision of concern which seeks to save money by preventing “non-emergent” emergency department visits. The legislation would task the Ohio State Medical Board with crafting a list of “non-emergent” conditions and associated symptoms.

At the invitation of Rep. Butler, Ohio ACEP attended an interested party about the provision and the topic of “ED Diversion.” Some of the information included in Rep. Butler’s presentation on the topic cited data that were incorrect or incomplete. Of particular concern was a study which found a majority of emergency department visits were non-emergent.

As a follow up to the interested party meeting, Ohio ACEP reached out to Rep. Butler to point out the results of more complete studies on the subject of emergency department use, including CDC data indicating only 4 percent of visits were deemed non-urgent in 2011.

In addition to data on emergency department use, Ohio ACEP also pointed out the most recent GAO (Government Accountability Office) report on Medicaid, which found the potential for cost savings in lower acuity cases is minimal.

Ohio ACEP also pointed out the inherent problems with devising a list of “non-emergent” conditions based upon presenting symptoms. Discharge diagnoses, of course, do not necessarily reflect the concern a patient may have about his or her symptoms. Chest pain at midnight that turns out to be gastroesophageal reflux would be listed as a diagnosis that could be provided as an outpatient, but the patient could not be expected to know it was safe to wait.

We thank Rep. Butler for hosting us for the interested party meeting and allowing us to share our perspective on the legislation. We appreciate the collaborative and open spirit with which he conducted the meeting and we look forward to working with legislators to improve the bill.

Look for Ohio ACEP action alerts and the latest information on HB 157 in future issues of our Advocacy Update.