Wojcik EM, et al. - In view of a rapid increase in the incidence of hepatitis C virus (HCV) among younger populations despite the recommendation from the Centers for Disease Control and Prevention for screening baby boomers and high‐risk patients for HCV, researchers here examined characteristics of HCV antibody‐positive (Ab+) and ribonucleic acid (RNA)‐confirmed‐positive patients recognized using two screening models in an Appalachian emergency department (ED). In this retrospective cohort study, they included 444 patients who were screened HCV Ab+. The median age was 39 years. From January to May 2018, 126 HCV Ab+ patients (4%) were identified among 3,014 screened patients using the risk factor model, whereas from June to October 2018, 318 HCV Ab+ patients (6%) were identified among 5,407 screened patients using the universal model. In this study, for the first time, characteristics were reported of HCV Ab+ and RNA‐confirmed‐positive patients who were recognized during the transition to a universal screening model in an Appalachian ED. Regardless of screening model, most diagnoses were new, however, under the universal model, more patients screened HCV Ab+, and a similar proportion were RNA‐confirmed‐positive. The models had high rates of reported intravenous drug use, and there was modest adoption of universal screening.