Stateline published an article that explores how care coordination approaches and programs can reduce unnecessary emergency department (ED) utilization. The article points to the success Washington State has seen to date with implementing a care coordination approach to address this issue, including by identifying frequent ED utilizers and connecting these individuals to care.
The article notes that the state has experienced nearly a 10 percent decline in emergency room visits among Medicaid beneficiaries in the first year of the program.
A study has found most insured people are motivated by a sense of urgency — not a preference for convenience — to visit a hospital emergency department for care. The findings are based on the 2012 Autoworker Health Care Survey, funded by the Center for Studying Health System Change and the nonpartisan National Institute for Health Care Reform. The survey of 8,836 active and retired nonelderly autoworkers and their spouses was conducted to learn how people decide to go to the ED.
The December issue of Health Affairsfocuses on opportunities and challenges for the future of U.S. emergency care. Studies in the issue, released Dec. 3, examine how emergency departments can become more integrated and innovative, ED quality measurement and strategies for reducing costs, among other areas.
At a Health Affairs briefing in Washington, D.C., Craig DeAtley, director of the Institute for Public Health Emergency Readiness at MedStar Washington Hospital Center, discussed the critical role hospitals play in emergency preparedness and standby capacity. DeAtley spoke about the “planning, training and exercising” hospitals regularly engage in to prepare for emergencies and disasters.
He noted that Hospital Preparedness Program funds were instrumental in hospitals’ preparedness efforts, but said reduced funding, shrinking staff size and other competing priorities were challenges for facility preparedness. The Health Affairs theme issue and briefing received support from the American Hospital Association and other organizations.
The American Hospital Association on June 10 voiced support for the Health Care Safety Net Enhancement Act (S. 961/H.R. 36), legislation that would provide medical liability protections under the Federal Tort Claims Act to hospitals and physicians providing emergency care. Specifically, the bill would extend to hospitals, emergency departments and physicians who provide services pursuant to the Emergency Medical Treatment and Labor Act the same medical liability protections given to employees of Community Health Centers.
“The increased costs that result from the current flawed medical liability system not only hinder access to affordable health care, they also threaten the stability of the hospital field, which employs more than 5 million people, and continues to be one of the largest sources of private-sector jobs,” AHA Executive Vice President Rick Pollack told the bill’s sponsors, Sen. Roy Blunt (R-MO) and Rep. Charlie Dent (R-PA). “…We look forward to working with you to advance this legislation and other proposals that will deliver meaningful medical liability reform.”
In this new Intelligence Report, HealthLeaders Media examines how resolving
organizational problems in the emergency department will remain a challenge as
demand for ED services increases, overcrowding elevates patient safety
concerns, and quality metrics draw greater attention.
Doctors in the emergency department are the major decision makers in nearly half of all hospital admissions, giving them a significant role in controlling healthcare costs, research shows. Read more from HealthLeaders Media here.
Fraud isn't at the root of a spike in providers' billing for emergency services, a new opinion piece in the New England Journal of Medicine asserts.
Rather, the piece's author writes, higher ER billing reflects both increasingly complex care provided in emergency departments over the past decade and more-accurate coding of that care.
Here are data based on comparative utilization and operational statistics collected by the Emergency Department Benchmarking Alliance from 358 participating hospitals, representing over 14 million emergency department visits.
ED metrics available include:
ED Patients / day
Percent with high CPT acuity rate
Percent pediatric patients
EMS arrival rate
EMS arrival admission rate
Hospital admission through the ED rate
Patients per care space
ECGs / 100 ED visits
X-ray studies / 100 ED visits
CT/MRI studies / 100 ED visits
LBTC (left before treatment completed) rate
ED length of stay for admitted patients
ED length of stay
These metrics are in five different size categories - from the low-volume emergency departments with under 20,000 annual ED visits up to the high-volume with over 80,000.
The findings of this research were that for certain emergency department operational performance measures, bigger (higher volume) is not better.
The American Hospital Association and four other national hospital groups on Sept. 12 urged Congress to oppose any legislative proposals to cap “total" payment for non-emergency department evaluation and management services at the rate paid to physicians for providing the services in their offices. The proposal, which originated with the Medicare Payment Advisory Commission, would reduce hospital payment by at least 71% for 10 of the most common outpatient hospital services.
“Simply put, it is significantly damaging to beneficiaries and the providers on which they rely to enact legislation that will result in such large cuts,” the letter states. In addition to AHA, the letter was signed by the Association of American Medical Colleges, Catholic Health Association of the United States, Federation of American Hospitals, and National Association of Public Hospitals and Health Systems.