Friday, July 06, 20076
Is EMTALA a money-maker for ER's?
A nurse feels that the EMTALA allows ER's to turn away non-emergent cases. Why don't they do it more often then?
What is interesting is that the act also states: "If the patient does not have an "emergency medical condition", the statute imposes no further obligation on the hospital".
So the question becomes why do we treat all of these people, 90% of whom do not have an "emergent medical conditions"? The answer would probably be because of the possibility of liability I suppose. Maybe a lawyer could make anything an emergency if given the opportunity.
Comments
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Blog, MD
I asked this question when I was a resident. I was troubled by the fact that our "triage" area never actually did any triage. I suggested that we change the sign to "Reception". I was told that the reason we never triaged the 3:00 am tinea capitis (ringworm) out the door was because the ED was a revenue generator for the hospital.
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Catron
Due to Kevin's wise policy forbidding ad hominem attacks, I'll refrain from using the adjectives that apply to the person who told you "the ED was a revenue generator."
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Blog, MD
Could it be a difference between pedi and adult ?
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Anonymous
Right - have a nurse miss anything at all, and the hospital, and probably the physicians on duty will get sued (not the nurse, of course).
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Catron
Could it be a difference between pedi and adult?
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Tyler
Thanks to EMTALA, hospitals are tasked with providing emergency care to anyone who needs it, regardless of ability to pay. Of course, many of the local emergency cases will be unable to pay, which means that from a business perspective, the ED is something like a loss leader. There are some very profitable ED patients, but generally speaking, there aren't enough to make the the ED profitable overall.
Post a Comment »8:05 AM
For most hospitals, the ED is a huge money loser, and EMTALA is the primary culprit.
8:31 AM
10:54 AM
As for being money makers, why are new hospitals being built without L&D and ED (EMTALA-bait) facilities?
1:19 PM
Nope. The finances of the ED are impossible, regardlesss of patient type. It may be that the person who told you that is conflating gross and net revenue.
6:52 PM
Part of the hidden cost of EMTALA is that by making care freely available only in emergency cases, it encourages people who have no ability to pay to wait until their minor complaints become emergent, thus compelling the hospital to provide care in a situation that is both more costly to everyone. ERs become more crowded, well-insured patients take more and more of their complaints to their PCPs, hospital financials deteriorate to the point where the hospital can't afford to invest in improving care in the overcrowded ED, and it looks like the whole situation could continue to get worse until the only patients you'll see in the ED are either dying (high severity) or broke (uninsured), and the hospitals are irreparably bleeding cash. Not a pretty picture.
If hospitals can figure out how to maintian a reasonably positive payer mix in the ED, they will stand a chance at bucking the trend.
3:49 PM