Abuse Of The Emergency Room 5

The U.S. Department of Defense has required Brooke Army Medical Center to seek reimbursement for medical procedures conducted on third party insured civilian patients. The need for a professional billing service to effectively acquire third party reimbursement for healthcare services within Brooke Army Medical Center is essential to the financial success of the organization. The hospital is operating in a demanding environment due to a highly regulated healthcare industry and an uneven playing field compared with other local community hospitals. Nearly one-third of the nation’s hospitals demonstrated operating losses in 2014 with Brooke Army Medical Center being no exception. Additionally, uninsured patients are costing U.S. hospitals $900

When focusing on the Centers for Medicare and Medicaid Systems strategies for improvement with unnecessary emergency room visits, a major key area is accessibility to health care at the appropriate health care setting. For many years, there has been the perception that the emergency department is the only place for someone who is uninsured or underinsured can go to receive the needed and appropriate health care, and in some situations that may be the case. (Rhodes et al, 2013, p.394) Due to the decreases in reimbursements for the publicly funded, more and more physicians are opting out to treating these patients, thus leading to an increase in emergency department utilization. According to a study conducted by Rhodes, Bisgaier, Lawson, Soglen, Krug, and Haitsma, this is becoming a greater concern for the

S (situation): Hi, my name Kelsey and I am a nurse in the emergency department. I am calling about Shannon O’Reilly’s most recent laboratory results.

The practice problem that this writer chose was psychiatric patients that are boarding in the emergency room that do not have a therapeutic environment. The website that this writer chose to use to research about the non-therapeutic environments for the psychiatric patients that are boarding in the emergency room is CINAHL complete. From this search of boarding psychiatric patient in the emergency room, eleven articles resulted. Boarding of psychiatric is all too common of an occurrence in the emergency room because of the decrease in inpatient psychiatric hospital beds. There has been a decreased in beds over the years in 1990 there was “3.7 beds per 1000 person” and in 2006, it decreased to “2.6 beds” (Nolan, Fee, Cooper, Rankin, & Blegen, 2015, p. 57). All of the article that were resulted from

2015 marked the first year in which reimbursements decreased for hospitals. The number one expense for the nation is healthcare (cms.gov, 215); with Medicaid and Medicare paying the largest amount. Scripps Mercy provides the majority of its services to Medicaid and Medicare patients; the ACA mandates an Electronic Health Record system to receive reimbursement (cms.gov, 2015). Ensuring a strong IT department is critical to Scripps success, particularly in regards to finances. As

Emergency room over utilization is one of the leading causes of today’s ever increasing healthcare costs. The majority of the patients seen in emergency rooms across the nation are Medicaid recipients, for non-emergent reasons. The federal government initiated Medicaid Managed Care programs to offer better healthcare delivery, adequately compensate providers and reduce healthcare costs. Has Medicaid Managed Care addressed the issues and solved the problem? The answer is ‘Yes’ and ‘No’.

Uninsured patients are charged directly but since they lack any market power, they are billed the highest. St. Anthony’s offers discounts to such patients and help with payment plan arrangements as well.

One of the primary goals of the Affordable Care Act (ACA) was to provide affordable health care coverage and increase access to affordable health care to the community. Unfortunately, since the passage of the ACA, while there has been an increase in the number of people with health care coverage, those same people do not necessarily have access to affordable health care. Currently, the public views the Emergency Department (ED) as a safety net by the community it serves; as demonstrated by the increasing number of people who continue to seek treatment in the ED for non-urgent problems. Utilization of the ED for non-urgent care contributes to the rising costs of healthcare as treatment in this setting can be upwards of three times the cost

One of the contributors to the rising cost of Healthcare can be attributed to the over use of emergency departments (EDs) for non-emergency needs. In the greater Capitol/First/Beacon Hill area there are three major hospitals (Virginia Mason, Harborview, and Swedish) with emergency rooms and no urgent care centers with the exception of Group Health which is restricted to Group Health insurance members.

Being admitted into a hospital can sometimes lead to many expensive medical bills. This is not a problem for the wealthy or middle class. However, for those who live in poverty or are even just in between jobs this presents a major problem. How will they be able to pay for these expenses?

The overall results are presented as a qualitative analysis and it allowed the researchers the opportunity to produce new inputs.

There are unique ethical and legal obligations of the Emergency Room Physician. Commonly faced issues include patient “dumping”, organ donation, and Do-Not Resuscitate orders. These issues have ethical and legal considerations for the Emergency Room Physician in regards to their responsibilities and actions.

Emergency room overcrowding is a major issue throughout not just the United States but in many countries. There have been many strategies on how to combat this issue as patient satisfaction is often being a major variable on hospitals being reimbursed, which interventions are most helpful? One intervention that is gaining more and more popularity is advertising wait times. Through a PICO search with key words of “ED triage” and “patient satisfaction” or “wait times” provided some great original research over the past five years that has been peer reviewed in the Journal of Canadian Association of Emergency Physicians. While multiple research papers came up, the methodology and potential of taking this particular study further was of great interest.

Flashing red and blue lights accompanied by an alarming siren in the distance is signaled when the double doors of the emergency room burst open. Pushed by several nurses, doctors, and other medical staff, a lone hospital stretcher with a bloody, wounded patient flies through the medical center towards the doors to the operating room. This image is what generally comes to mind when you think about an emergency room. Many people believe that the hospital’s emergency room is a dark and scary place. While this is true, the common misconception is that the emergency room is a place clear of humor, when in reality humor is present, even necessary, for many reasons. Many television shows, like the show ER, are based in the setting of the

The emergency room has become the new primary care facility for the millions of uninsured in the United States. Thanks to an “unfunded mandate passed into law in 1986,” hospitals that participate in the Medicare program must “screen and treat anyone with an emergency medical condition” (Stephens & Ledlow, 2010). This unfortunately leads to emergency rooms full of people who may have something as simple as a sinus infection which then makes it really difficult for someone with a real emergency that did not require ambulatory transport to be seen in a timely manner. Another unfortunate result of this is that “over 1,100 emergency departments closed over the past decade” (Stephens & Ledlow, 2010).