Abusing The Emergency Room

Body 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

Part A : Key outcomes achieved through the implementation of the ACA in 2010. Access, Cost and Quality: ACA expanded Medicaid to all Americans below 133% of the federal poverty level from the previous cut-off at 138 percent. The enrollment for Medicaid and CHIP has been simplified. ACA prohibits insurance companies from

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’.

Situations like Maria’s have become fairly common here in the United States. In 2014, Pew research estimated that there are 11.3 million unauthorized immigrants in the United States (Krogstad & Passel). In 1986, the Emergency Medical Treatment and Active Labor Act (EMTALA) made it possible for unauthorized citizens to qualify for Emergency Medicaid. Moreover, any hospital which is eligible to receive Medicaid reimbursements is required to treat ANY patient with emergency medical treatment (Sultan). Prior to the Affordable Care Act (ACA), hospitals could also receive reimbursements for patients who those who needed non-emergent

The Obamacare/ACA, might have helped numerous of individuals in acquiring health care, but the health professionals are facing a shortage of reimbursement difference for their services. As a result, Hospitals and healthcare providers were force to layoff personal and come up with innovative solutions. This point is proven by the renowned author, Amy Anderson by stating as follows: “The American health care framework has had shortages of personnel for quite some time and would not be prepared to give the adequate service to this amount of patients in need of medical attention. Training new professional health services personnel could take years. There is a shortage of graduates from medical and nursing schools. Doctors, nurses and health professional are sharing responsibilities prospective patients will face a longer wait time”. (Anderson, 2014)

Affordable Healthcare Acts Impact on Hospitals The Affordable Healthcare Act is expected to increase medical coverage to include an additional 30 million people. What has become clearer is that just because coverage was expanded does not mean an expansion of actual care. “When Congress enacted the national health law, it unleashed a potential tsunami of newly insured patients, flooding a delivery system that was already strained and fragile. The American health care infrastructure has had workforce shortages for decades and is not prepared to meet such a vast influx of patients effectively or efficiently” (Anderson, 2014). It takes years to train nurse and doctors of which the healthcare act does not take into consideration. What ends up happening is

Promoting a Healthier Texas Through Medicaid Expansion Current Status: Texas ranks number one with the highest uninsured rate in the nation, accounting for nearly 6 million people (1). The federal government has nearly $100 billion for Medicaid expansion, out of which $15 billion is needed for expansion in Texas (1).

The ACA was created to help insure a larger portion of the nation’s population and give people access to affordable and higher quality care. Unfortunately, the ACA completely excludes undocumented immigrants from the eligibility of the program, even though this population consists of 11 million, which is a huge chunk of the nation’s population. As a result, the undocumented population is left with Emergency Medicaid, which is a program that is a part of ACA. This program gives some limited assistance to undocumented individuals in a case of an “emergency” or pregnancy related issues. Emergency Medicaid does not cover any type of prevention care or offer primary physicians to patients. It is also important to note that if the hospital determines that the visit was not an emergency, then the patient is left with a high medical bill that they would not be able to afford possibly leading to bankruptcy.

Beaufort Memorial Hospital, Beaufort, SC is no exception to this rule. With much of Beaufort County and the surrounding counties being rural and with a high poverty rate Beaufort Memorial experiences a high level of underinsured and indigent care. In 2012 the Medicaid

Affordable Healthcare Acts Impact on Hospitals Gloria Panhorst HC461 The Hospital and the Community Instructor: Justin Villines April 13, 2015 Abstract On March 23, 2010, President Barack Obama signed the Affordable Healthcare bill into law. There has been much controversy over this Affordable Healthcare Act before and since it was signed into law. It

ED THROUGHPUT 2 Introduction A visit to the emergency department (ED) is usually associated with negative thoughts by most people. It creates preconceived images of overcrowded waiting rooms and routine long waits for treatment (Jarousse, 2011). From 1996 to 2006, ED visits increased annually from 90.3 million to 119.2 million (32% increase).

Affordable Healthcare Act and the Impact on Hospitals Gloria Panhorst HC461 The Hospital and the Community Instructor: Justin Villines April 13, 2015 Abstract On March 23, 2010, President Barack Obama signed the Affordable Healthcare bill into law. There has been much controversy over this Affordable Healthcare Act before and since it was signed into law.

Background and Significance One of the goals of Healthy People 2020 is to increase access to health care, specifically through reducing “the proportion of persons who are unable to obtain or delay in obtaining necessary medical care” (Healthy People 2020) from 4.7 percent to 4.2 percent. The Center for Medicare Advocacy,

              America needs comprehensive health care reform, and immigrants should be a part of the movement.  But many American citizens might ask that pertinent question: why should they cover the expense for illegal immigrants to access health care?  The answer is plain and simple: until congress passes immigration laws that work, people are

Today people in America go to the Emergency Room for everything. Whether they skinned their knee, have muscle pain, or even a papercut. They don't even try to just put a band aid on it themselves, instead they go to the ER. There are people who take their kid to the ER for a cold when all they have to do is pick up some cough syrup. People don't need to go to the ER for these reason. They either need to go buy band aids, or go to their family care provider. A reason for this influx in visit to the ER is do to the EMTALA Emergency Medical Treatment and Active Labor Act. This bill made it were Emergency Departments can’t turn people away for not-payment. This is good to cover people who really need treatment that they can't offend, but also allows people who don't need to be in the ER to come because they can't get turned away. This has shifted American healthcare model to go to the ER for every bump, bruise, and stomach ache you feel, and not only do you have to wait 4-6 hours to be seen, but are taking an bed from someone who really needs it.