HCA 5303 Unit IV

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Columbia Southern University *

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5303

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Health Science

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Jan 9, 2024

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1 Unit IV Journal Sean Burton Master’s Student HCA 5303 Dr. Merle Point-Johnson 12/01/2023

2 Unit IV Journal For our Unit IV assignment I have reviewed the article Examining EMTALA in the era of the patient protection and Affordable Care Act . This paper will share my understanding of what unanticipated consequences have occurred from this legislation, and what some of the unanticipated benefits were. In closing I will give an example of what measures a chief executive officer of a health system might implement to stop these issues from negatively impacting their health care system. Unintended Consequences In 1986, the EMTALA established that emergency medical patients could be refused care or transferred to another hospital without undergoing appropriate screening and stabilization (Greenwald, 2022) . EMTALA was implemented with the intention of ensuring the protection of patients, however it has resulted in unforeseen repercussions. An unanticipated consequence of EMTALA is its influence on emergency rooms and medical facilities. Emergency services are essential as they ensure that all individuals, irrespective of their financial status, undergo screening and receive immediate stabilization. The surge of patients overwhelms emergency rooms (EDs), resulting in longer wait times, overcrowding, and potentially compromising the quality of both urgent and non-urgent care (Charleen Jsuan, 2018) . Another unforeseen consequence is the financial burden on hospitals. Hospitals are obligated by EMTALA to provide medical treatment to all individuals in need of emergency care, regardless of their financial status or insurance coverage (Greenwald, 2022) . The incidence of uncompensated care, in which hospitals bear the cost of unpaid services, is increasing. Smaller

3 hospitals or those catering to low-income communities may encounter difficulties in coping with this financial burden. EMTALA has been criticism for the practice of "boarding" (Charleen Jsuan, 2018) patients in the emergency room, resulting in prolonged waiting times for admission. These factors may result in service delays, decreased productivity, and unfavorable patient outcomes. The approach does not effectively tackle underlying structural problems such as the shortage of hospital beds and inadequate mental illness care, which are the root causes of the boarding issues. EMTALA may potentially incentivize the practice of "defensive medicine," (Charleen Jsuan, 2018) wherein doctors order superfluous tests and treatments as a precautionary measure to mitigate potential legal consequences for failing to diagnose or treat a patient. Implementing this defensive tactic could potentially exacerbate patient outcomes and escalate healthcare expenses. Consequently, although EMTALA aims to safeguard individuals in need of urgent medical care, it has inadvertently led to difficulties such as overcrowding in hospital emergency departments, financial strain on healthcare institutions, challenges with patient boarding, and a squandering of medical resources. To address these unintended consequences, a comprehensive approach that considers legal frameworks and systemic inequalities in the healthcare industry is necessary. Unanticipated Benefits EMTALA has had unintended benefits that have benefited healthcare. Improved emergency treatment for the poor is a major benefit. EMTALA requires everyone to receive

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