Extending affordable health coverage to twogroups targeted by the Patient Protection and Affordable Care Actmay be working to reduce the medical costs of those patients.

The groups — young people under the age of 26 and Medicare patients enrolled in federallydesignated patient-centered medical homes — showed a slightreduction in the number of emergency room visits since they havehad coverage.

The American College of Emergency Physicians released theinformation, drawn from two studies: one by researchers at PurdueUniversity that concentrated on young people; and another fromGeorge Washington University that looked at the older populationgroup.

Health care reform advocates has particularly wanted to extendcoverage to these groups. Young people tended not to seek coverageprior to its greater availability under the law. The older group, ahigh-cost coverage niche, in theory now has better coverage that isin part designed to reduce ER visits.

While the studies did reveal fewer ER visits, it also found no change in ERvisits that lead to hospitalization — the most expensive of ERtrips.

“The concept of 'medical homes' has been around since the 1960sand reviews of their effectiveness in improving health outcomeshave been mixed,” said lead study author Jesse Pines at the GeorgeWashington University School of Medicine and Health Sciences inWashington D.C. “Our study shows that these models can have apositive effect on patients, as far as limiting outpatientemergency department use, but they don’t seem to keep patients frombeing hospitalized, which is many times more expensive than ERvisits.”

The study of those ages 19 to 25 with health coverage reported adecrease in ER visits of 1.6 per 1,000 people. Most of the decreasewas attributed to young women making “weekday visits [for]non-emergency conditions and conditions that could be treatedoutside the emergency department,” the study said.

“The reductions in ER use among young people were quite specificto less severe conditions that could be handled in a primary caresetting, which is not unexpected,” said lead study author Yaa AkosaAntwi of Indiana University-Purdue University in Indianapolis.“Overall, the reductions in ER use were modest, which suggests thateven when the ACA is fully implemented, population-level changes inemergency department use may also be modest.”