Patients facing an emergency generally make the right call. In a recent study, researchers from the University of California at San Francisco found that only 3.3 percent of emergency department visits can be considered “avoidable.” The research shows that defining what constitutes an “avoidable” visit is arbitrary, and determining this after the fact overlooks the disparity between initial symptoms and final diagnosis. Understandably, it is difficult for anyone other than a licensed medical practitioner to classify symptoms as an emergency.
Unfortunately, a local insurer has taken action to increase the fear and worry around emergency department visits. Anthem Blue Cross Blue Shield changed its emergency department policy for Kentucky policyholders earlier this summer, citing the need to unburden overcrowded emergency rooms and decrease the high costs of emergency care. As of July 1, if you go to the emergency department with an issue later determined not to be an emergency, Anthem may not cover your visit.
As long-time health care advocates, we want to highlight this study and urge Anthem to fix its policy. We believe it violates the basic tenets of the insurer/patient agreement and provides yet another example of abusive practices that prevent Americans from accessing quality health care.
Donna Christensen, M.D
Consumers for Quality Care Board