3 important steps to reform hospital-based emergency care

Hospital-based emergency care in America is unraveling. The symptoms are everywhere — long wait times, overcrowding, patient frustrations, workforce shortages, clinician burnout and even complete closures of rural and community emergency departments. 

These symptoms signal a fundamental problem: the mismatch between the demand for acute unscheduled care (strokes, heart attacks, trauma, etc.) versus the capacity and resources available to deliver it.

When emergency departments function well, patients receive timely access to high-quality clinical care. When they struggle or fail, patients lose a federally guaranteed 24/7 point of access to care, available regardless of the patient’s ability to pay. 

A recent RAND study articulates the value that emergency departments provide to healthcare stakeholders. Health systems lose capacity for acute unscheduled care. Primary care physicians lose an on-demand resource for complex patients. Communities lose a hub for care coordination and a treatment center for uninsured patients. Payors lose a guaranteed network of emergency physicians. Public health and disaster response entities lose standby capacity and critical resources during emergencies.

Despite this, emergency physicians have experienced repeated reimbursement cuts, no inflation increases and often, no reimbursement at all for public health functions that benefit patients and the healthcare system. Unlike many other specialties, emergency departments cannot reduce patient care services to align with reduced resources, even to ensure their own economic sustainability. As a result, they are closing at alarming rates, especially in rural and underserved settings.

These closures have largely been regarded as........

© The Hill