WHY IT MATTERS:
A new Vizient report shows a 67% rise in high-acuity emergency visits in 2023, driven largely by noncardiac chest and abdominal pain. Patients admitted through the ED spent nearly 13 hours waiting—more than double the time for those discharged. High patient volume combined with longer care time places enormous strain on both healthcare systems and staff.
The Emergency Department (ED) serves as the gateway to the U.S. healthcare system for many adults. So far in 2025, the U.S. has seen over 155 million ED visits, highlighting that complex and acute conditions are increasingly driving people to the costliest outpatient care setting. While many factors—age, gender, race, income, employment, and geography—affect ED utilization, vulnerable populations like the uninsured and infants dominate visits. Notably, 56% of visits were covered by Medicaid or Medicare, and nearly 30% were commercial, showing the clear impact on employer-sponsored health plans.
WHAT EMPLOYERS CAN DO:
With an aging and multigenerational workforce, employer-sponsored health plans face challenges in keeping employees healthy while controlling costs. ED visits—especially for non-emergent issues—can increase plan costs, absenteeism, and lost productivity. Lower utilization is often linked to better access to preventive care, care navigation, chronic disease management, primary care providers, and medications. Employers should ensure their health plans support a total health and wellness approach.
ACTION STEPS:
- Request data from your carrier on ED utilization: non-emergent visits, admissions, and diagnostic categories.
- Analyze whether visits are truly emergent or could be addressed in urgent care or primary care settings.
- Identify opportunities to improve care, reduce costs, and support employees.
HOW OPTIMATUM SOLUTIONS CAN HELP:
We work with your carriers to request and analyze critical ED data, including visit volumes, admissions, 24-hour stays, demographics, and diagnostic categories. This insight identifies opportunities for better care and cost savings—benefiting both employees and employers.
SOURCES:
Emergency Department Visits Statistics in the U.S. 2025 | EDV Facts – The Global Statistics