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'We want people to seek care in the most appropriate setting possible' | SC ER visits for COVID-19, COVID-like symptoms cost Medicaid more than $60M

Even with the rise in COVID cases, South Carolina Medicaid data shows overall emergency room visits for people with COVID-like symptoms were down compared to 2019.

CHARLOTTE, N.C. — Roughly one out of every five Medicaid patients who visited South Carolina emergency rooms with COVID-like symptoms actually received a COVID-19 diagnosis, according to WCNC Charlotte analysis of ER data.

Those visits alone cost taxpayers at least $11.5 million in addition to the $50 million paid to treat patients who actually had COVID-19.

However, Medicaid claims show, even with the rise of COVID-19, fewer people visited the emergency room for things like headaches, fevers, sore throats and coughs during the pandemic than they did in the year leading up to March 2020.

"I think that's a factor of people really not engaging as much in society," South Carolina Department of Health and Human Services communications and public relations director Jeff Leieritz said.

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Preliminary South Carolina Medicaid data, which is a snapshot of low-income patient behavior, suggests the strain on hospitals and emergency rooms would've been more significant had people not locked down. The data shows, compared to 2019 numbers, there were fewer ER visits for COVID-like symptoms during nearly every month of the pandemic until August 2021.

Leieritz said the agency's efforts to make telehealth more accessible at the beginning of the pandemic likely had an impact, too. Data shows telehealth visits skyrocketed.

"That was really designed to keep people out of the emergency room for things that were not really emergent situations," he said. "We're always very conscious of the fact that we're a taxpayer-funded department and we have a lot of measures in place to try to encourage people to seek care in the most appropriate and least costly setting that will suit their needs."

Credit: WCNC Charlotte
Frequency of COVID and COVID-llke symptoms as primary diagnosis

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As more claims come in for the end of 2021, Leieritz expects the number of 2021 ER visits for COVID-like symptoms to eventually eclipse 2019 numbers, likely made worse by people who misused ERs. 

"We have heard from hospitals, anecdotally, that there are people that are going to an emergency room for a COVID test, just for a COVID test," Leieritz said.

Emergency rooms are among the most expensive places to receive medical care. Data show Medicaid's funded $1 billion worth of ER visits in South Carolina alone from March 2020 through December 2021.

"We really want to make sure that the emergency rooms are available for people who are in an emergent situation," Leieritz said. "We want people to seek care in the most appropriate setting possible."

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The data shows COVID-19 was the second leading ER diagnosis during the pandemic so far behind acute upper respiratory infections.

Contact Nate Morabito at nmorabito@wcnc.com and follow him on FacebookTwitter and Instagram.

WCNC Charlotte is part of seven major media companies and other local institutions reporting on and engaging the community around the problems and solutions as they relate to the COVID-19 pandemic. It is a project of the Charlotte Journalism Collaborative, which is supported by the Local Media Project, an initiative launched by the Solutions Journalism Network with support from the Knight Foundation to strengthen and reinvigorate local media ecosystems. See all of our reporting at charlottejournalism.org.  

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