Annals of Emergency Medicine study shows declining trend in emergency department payments

February 26, 2003

A study in the March 2003 issue of Annals of Emergency Medicine shows an overall declining trend in emergency care payments, with the most significant payment decline noted among the privately insured. (Declining Payments for Emergency Department Care, 1996-1998, p. 299)

"The study shows that only a little more than half of all emergency department visits are paid, and these payments continue to spiral downwards," said Rita K. Cydulka, MD, MS, of Case Western Reserve University in Cleveland, Ohio, and a co-author of the study. "Declining overall payment rates increasingly threaten the ability of emergency departments to provide emergency care to all regardless of ability to pay--as America's health care safety net."

Based on data from the Medical Expenditure Panel Survey, a nationally representative survey of the U.S. population conducted by the U.S. Agency for Healthcare Research and Quality (AHRQ), researchers found that from 1996 to 1998, the rate of payment for emergency department charges declined from 60.3 percent to 53 percent. In 1998, of $30.6 billion charged for emergency care only $16.2 billion was paid, compared with $17 billion paid out of $28.1 billion charged in 1996.

The largest decrease in payments was among the privately insured, who paid 75.1 percent of charges in 1996 and 63.4 percent in 1998. Total proportion of charges paid by Medicaid (34.5 percent), Medicare (43.9 percent), and the uninsured (47.7 percent) remained constant during this time period.

"The study indicates that the ability to recover losses from uninsured patients by 'cost shifting' to other payers is becoming more difficult, largely because managed care has eliminated the financial margin previously used for this purpose," said Dr. Cydulka. "The problem likely will become worse, since the number of uninsured patients is increasing.

"In addition, while we did not study whether charges reflect increases in true resource costs, we know from other research that patients seeking emergency care are sicker than ever before and require more emergency department resources, which would result in increased charges," added Dr. Cydulka. "If this is the case, the declining overall payment rate further illustrates the fiscal health of emergency departments is worsening."
-end-


American College of Emergency Physicians

Related Emergency Care Articles from Brightsurf:

Emergency care doctors not getting sufficient 'down time', new study shows
A survey of more than 4,000 UK emergency care doctors has shown that they need more support to recover from work pressures between shifts.

Transportation barriers to care may increase likelihood of emergency surgical intervention
Transportation barriers, such as personal access to a vehicle or public transportation, disproportionally affect minority communities.

Clear will and capacity to help emergency care in crisis
Operators beyond the confines of conventional emergency healthcare are willing and able to assist in a crisis, a University of Gothenburg study shows.

Palliative Care in emergency departments during COVID-19 pandemic
The clinical characteristics and outcomes of patients who received intervention by a COVID-19 palliative care response team are examined in this case series.

Academic emergency departments are always open to all who need care
''Academic emergency departments never deny emergency care to any person.'' That is the statement put forth in a commentary from the Board of Directors of the Society for Academic Emergency Medicine and the Senior Editorial Board of Academic Emergency Medicine journal.

Overuse of emergency room reducible through primary care relationship
Using the case of lead exposure in Flint, Michigan, health economist David Slusky and colleagues found that establishing a relationship with a primary care physician for a child reduced the likelihood parents would take them to emergency rooms for conditions treatable in an office setting.

Providing contraceptive care in the pediatric emergency department
A new study found that two-thirds of female adolescents ages 16-21 seen in a pediatric Emergency Department (ED) were interested in discussing contraception, despite having a high rate of recent visits to a primary care provider.

Dogs reduce distress of patients waiting for emergency hospital care
A visit from a dog can reduce the distress of patients waiting for emergency treatment in hospital, a study by the University of Saskatchewan (USask) shows.

Kaiser Permanente improves emergency care for patients with chest pain
Emergency physicians at Kaiser Permanente hospitals in Southern California reduced hospital admissions and cardiac stress testing by using new criteria to assess the level of risk patients with chest pain have for subsequent cardiac events.

Women less likely to receive geriatric care for emergency hip surgery
More than 70 percent of patients receiving surgery for hip fracture are women, yet they are less likely than men to receive geriatric care during hospitalization, or an anesthesiology consultation before surgery, found a study published in CMAJ (Canadian Medical Association Journal).

Read More: Emergency Care News and Emergency Care Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.