10% To 26% Of Emergency Department Visits – Depending On Payer – Made By ‘Superutilizers’

Between 10.5% to 26.2% of emergency department (ED) visits in 2014 — depending on the payer in question (Medicare, Medicaid, or private insurance) — were made by consumers called “superutilizers” who made at least four ED visits during the year. A superutilizer is defined as a consumer aged 1-64 years covered by Medicare or Medicaid with six or more ED visits in a given year, or a privately insured consumer aged 1-64 years or Medicare beneficiary aged 65 years and older with four or more ED visits.

Superutilizers visited the ED an average of five to 10 times . . .