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Source: American Medical Association
A recent federal report casts more concern that hospital emergency rooms are having increasing difficulty treating all comers, especially because federal payments and the uninsured don't pay their full cost of care.
"There is a growing concern that EDs will not be able to sustain care for all persons in the current economic environment," according to the report, entitled "Payers of Emergency Department Care, 2006," that was published by the U.S. Agency for Healthcare Research and Quality.
"Between 1993 and 2003, there was a 23% increase in ED visits and a closure of 425 hospital EDs. In addition, a recent Institute of Medicine report notes that EDs have become increasingly overcrowded, overburdened, and underfunded. Yet little is known about who is paying for ED care, what the charges are for the care, and how to potentially relieve this pressure," the report said.
Of all visits to hospital emergency departments in 2006, 41.8% of the care was billed to the federal government–21.6% to Medicaid and 20.2% to Medicare. Another 17.7% were uninsured. An estimated 34.6% was billed to private insurance, and the rest to other private payers.
Read the full story by HealthLeaders Media’s Cheryl Clark.
Medicaid's "cumbersome" policies often lead to patients not getting or filling their prescriptions, receiving important diagnostic tests, or managing their chronic disease, which will lead to more costs down the road, according to a new report released by the Association for Community Affiliated Plans.
The Medicaid system, which varies by state, requires beneficiaries to show proof more than once a year that they and their children are still eligible for the public program. This leads to many falling off the rolls, which is a cycle that interrupts their continuity of care and jeopardizes their health.
Additionally, with so many people "churning," which means dropping out and back in to the Medicaid rolls every few months, the federal goal of measuring the quality of the patient care has become extremely problematic if not impossible, according to the group, which represents 42 nonprofit safety-net health plans serving six million beneficiaries in 23 states.
Read the full story by HealthLeaders Media's Cheryl Clark.
The last thing you want to learn at your hospital, as a patient sits at your registration desk:
- They can't pay, and no one knew prior to service
- Their insurance changed, and authorization is required
- They recently lost their job and have not paid their COBRA benefits
At this point, you may end up with an unpaid account—and in this economy, that's not good news when hospitals continue to lose reimbursement dollars.
Read the full story by Dom Nicastro.
The patient access team at Skagit Valley Hospital has many goals as it works through this economic recession: Sustain morale, maintain trust, minimize criticism, and acknowledge success.
Michele Hill, CHAM, patient access manager at the Mount Vernon, WA, facility, knows it's not easy considering what the hospital faces:
- Federal and state budget cuts
- Change in payer mix
- Increased charity care requests
- RAC audits
"Our facility, like many others, is facing significant challenges during this time of economic downturn," Hill says.
Read the full story.
Despite a recession and continued crowding, a new study shows that the average wait time in the nation's emergency departments fell by two minutes in 2008 to 4:03. Even with the long waits, Press Ganey's Emergency Department Pulse Report 2009 finds that patient satisfaction rose in 2008, continuing a five-year improvement trend.
Leigh Vinocur, MD, on the emergency physician faculty at the University of Maryland School of Medicine, says she's not surprised that patients leave the ED satisfied.
"First of all, they probably can't get in to see a primary care doctor," says Vinocur, who is also a national spokesperson for the American College of Emergency Physicians. "And when you go to a doctor's office, he decides you could need a CT scan or a neurologist and you're waiting another few weeks for a referral.
"So, even though people are waiting four and five hours in the ER, they have an idea they are going to have a diagnosis when they leave. That doesn't always happen. But we can do a lot of procedures and things while you are there to get closer to the diagnosis," she says.
Read the full story by HealthLeaders Media’s John Commins.
Sometimes, your health information managers need to code. And your patient access managers need to register patients.
In these tough economic times, your hospital staff members should be ready for different roles on any given day. No one is immune to change.
At Albany (NY) Medical Center, managers in the patient access department are prepared to handle staff shortages.
During a recent string of illnesses and consecutives days with short staffs, department leaders took off their managers' hats and got on the frontline to register patients.
"The leadership team are working managers, much like any other patient access area," says Cathy Pallozzi, CHAM, patient access director at Albany Medical, noting the staff recently experienced colds and GI, which sprang the managers to action. "So the managers are on the front end, as well as the associate director. If I am needed, I will be on the front end as well."
Read the full story.
Hospitals can't escape layoffs these days, and they're not adding many jobs any time soon.
Bureau of Labor Statistics data released Friday say hospitals added only 300 payroll jobs across the entire nation, compared to 16,800 jobs in May 2008, and 8,700 jobs in May 2007.
So what are hospitals doing about it, especially on the front end where accurate registrations and upfront collections can mean the difference between a denial and a full return on a patient bill?
They are getting smarter, more technologically savvy, and analyzing their payer mix and what each entity requires.
Read the full story by HealthLeaders Media's Dom Nicastro.
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