A groundbreaking study by the RAND Corporation, funded by ACEP’s EMPI, analyzing over 50 million emergency department (ED) professional claims across four years reveals an alarming trend: The ED safety net in the US is unraveling and unsustainable. See the infographic below for some of the key data points and be sure to check out Darshan Patel’s overview here.
Description of Infographic:
US Emergency Department Physician Payment Crisis
- 20% of all US ED physician expected payments went completely unpaid.
- $5.9 billion per year of unpaid ED EMTALA-mandated physician services.
- Medicare and Medicaid payments to ED physicians both fell 3.8 percent per visit and total nearly 30% over the past decade when indexed to inflation.
- Commercially insured patient visits payments dropped 10.9% for in-network visits and 47.7% for out-of-network visits.
- The critical ED safety net is frayed, and patient access is threatened – policy and payment reforms are essential.
Reimbursement change is essential to preserve the ED safety net. Advocacy strategies include:
- Requirement for insurers to collect copays, deductibles and coinsurance from patients with full payments to providers
- Combine Medicare Parts A and B and ensure physicians are also given inflationary adjustments
- Allow physicians to deduct unfunded EMTALA monetary losses from taxes
- Utilize funding from the CDC and Dept of Defense as revenue sources for health screening and disaster preparedness
- Hold insurers accountable for the contractual amount obligated to physicians
- Provide DSH payments to physicians and not just facilities for undercompensated care
