Medi-Cal ER Encounters Zoom Upward

The expansion of the Medi-Cal program under the Affordable Care Act has fundamentally reshaped how emergency room encounters are paid for in the state, according to new data from the Office of Statewide Health Planning and Development.

According to OSHPD, the number of ER patient encounters paid for under Medi-Cal zoomed from about 800,000 annually in late 2013 to an annual rate of 1.35 million by the fourth quarter of last year, an increase of 70%.

According to data from the California Department of Health Care Services, statewide Medi-Cal enrollment grew from 8.6 million from the end of 2013 to 13.3 million at the end of 2015, an increase of 55%.

The number of encounters involving uninsured patients dropped from 400,000 in the first quarter of 2014 to 236,455 by the fourth quarter of last year, a drop of more than 40%.

Medicare encounters grew by about 20%, from about 430,000 a year in the fourth quarter of 2013 to 525,855 by the end of 2015.

OSHPD declined comment on the data.