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Illinois Hospitals to Cut Services to Pay for Opioid Overdoses of Uninsured Patients

A February 16th article in Crain’s Chicago Business covered the increase in opioid-related overdoses and their impact upon hospitals in Illinois. The number of overdoses is rising, but so are the costs associated with treating these patients. Between January-September 2016, the number of opioid-related emergency room visits was 77% higher than that same time period just a year before. Nationwide, the average cost of an intensive care unit stay for an overdose was $58,517 in 2009. In 2015, the average cost per ICU stay jumped to $92,408.

A representative for Cook County Health and Hospital System told Crain’s that they estimate they spent $25 million last year treating between 4-5,000 patients with opioid-related illnesses. As a point of comparison, they treated 1,000 of these patients in 2006.

Loretto Hospital says that 1 out of every 3 patients in the emergency room is there to be treated for an opioid-related issue. They also estimate that nearly 40% of the patients admitted for treatment are later readmitted, something that costs them more than just writing off a single visit. Readmission rates have been a major quality indicator for hospitals and under the Center for Medicare and Medicaid Services “Readmissions Reduction Program,” hospitals who have high readmittance rates will see reduced payments from Medicare and Medicaid. For many hospitals, Medicaid reimbursements make up a large chunk of their revenue.

Since 2010, Illinois hospitals have been able to manage costs associated with treating the increasing number of opioid users because the Affordable Care Act increased the number of insured Americans. Whether it was the fear of financial penalties or just those genuinely wanting health insurance, more insured patients meant smaller tabs for hospitals to have to write off. Cook County Health and Hospital System said that 84% of patients they currently treat in their hospitals and clinics have health insurance, compared to just 46% in 2013. However, with the Trump Administration removing the penalty for not having health insurance, hospitals fear that they will have to make cuts to other services in order to cover the exorbitant and increasing costs of treating patients who have overdosed or are seeking treatment for opioid-related illness and conditions.

Where does Your County Place in Overdose-Related ER Visit Rankings?
The list of top 10 Illinois counties with opioid-related ER visits in 2016 does not include Cook County, nor does it include the counties of DuPage, Kane, Lake, McHenry, or Will, commonly referred to as ”collar” counties. In the city, the top areas with overdose-related deaths were Burnside, North Lawndale and West Garfield Park.

While it may seem surprising that the city (and Cook County in general) doesn’t place in the top 10 for overdose-related hospital visits, experts suspect that there are several factors at play that lead to more overdoses in rural Illinois:

  1. The nature of work done by those in the top 10 counties tends to be more labor-intensive, leaving employees more prone to injuries that may require an opioid prescription.
  2. The number of physicians offices, clinics, and hospitals are more spread out in these areas, which may influence the way practitioners prescribe medicine. It is suspected that these providers prescribe larger doses, since follow up visits are less likely to occur.
  3. There are fewer specialists such as physical therapists, chiropractors, or acupuncturists to provide alternative methods for pain relief.

Need for Treatment Clinics and Access to Anti-Overdose Drugs
The concern of hospitals to be able to treat these patients without cutting back on other life-saving services is a valid one. It is against the law to refuse emergency medical care to someone for any reason, even if they are uninsured.

Cook County Health and Hospital System described to Crain’s their plans to help combat the uptick in opioid overdoses. In addition to a newly-opened treatment center on the South Side, they also plan to open one on the West Side.

Law enforcement and Illinois first responders are also doing their part to help combat opioid-related overdoses and deaths. In September 2015, Illinois passed a new law, officially called P.A. 99-0480, that requires police, EMTs, and firefighters to receive training and be supplied with Naloxone (more commonly known under the brand name Narcan), the overdose combatting drug. While a deadline for implementing this law has not been officially put in place, many police and fire departments have already undergone training and have begun using the drug.

However, experts project that by the year 2020, nearly 3,000 Illinois residents will die from an opioid addiction. The short term fixes are just a small part in cutting back on the number of deaths, but health experts are concerned that without inpatient and outpatient treatment centers to address the root of the issue, the number of deaths might decrease slightly, but the number of those addicted will continue to rise.