International Journal of Economy, Energy and Environment
Volume 2, Issue 6, December 2017, Pages: 104-108
Received: Oct. 30, 2017;
Accepted: Nov. 20, 2017;
Published: Dec. 14, 2017
Views 966 Downloads 35
Pamela Treister, Department of Nursing, New York Institute of Technology, Old Westbury, New York, USA
Ruth Conboy, Department of Student Affairs, Philadelphia College of Osteopathic Medicine, Philadelphia, USA
Lori Smittle, Westchester County Department of Health, Westchester, New York, USA
Christina Carter, Workforce Analytics for Healthcare, Kronos Inc., Arizona, USA
Leah Lucarelli, Cornell Scott-Hill Health Center, New Haven, Connecticut, USA
Erin Kampa, Norwalk Community Health Center, Norwalk, USA
Prior to 1986, emergency department staff was both morally and ethically obligated to provide care that included the stabilization and treatment of all patients who presented to the emergency department, regardless of their ability to pay. In 1986, this moral and ethical obligation became federal law with the passage of the Emergency Medical Treatment and Labor Act (EMTALA), which required any patient coming to an emergency department be stabilized and treated regardless of their insurance status or ability to pay  . Hospital emergency departments are a critical entry point into the American health care system. The patient population is a combination of the privately insured, including high deductible health plans, the uninsured, and the underinsured. Although emergency treatment is covered under EMTALA, hospitals are left to deal with the bills accumulated from non-emergent daily medical care. The increase in volume places tremendous burden on hospital emergency departments, with high overhead and fixed costs. Many facilities cannot keep up with costs and are forced into bankruptcy, leading to overcrowding in nearby hospitals. More thought must be placed on how hospitals can bear the burden of uncompensated care. Access to care is not enough; it’s crucial that care be affordable. Addressing uncompensated care in the emergency department can be done successfully. The staff is proficient in saving lives, now they must learn to put the same effort into saving money.
The Financial Impact of Uncompensated Care in the Emergency Department, International Journal of Economy, Energy and Environment.
Vol. 2, No. 6,
2017, pp. 104-108.
EMTALA. (2014). American College of Emergency Physicians. Advance online publication. www.acep.org. EMTALA (2005).
American College of Emergency Physicians, http://www.acep.org/content.aspx?id=25936, American College of Physicians, 2011, http://www.acponline.org/advocacy/where_we_stand/assets/natl_immigration.pdf.
Weiss, A. J., Wier, L. M., Stocks, C., & Blanchard, J. (2014). Overview of emergency department visits in the United States, 2011.
Gusmano, M. J. (2012). Undocumented immigrants in the United States: U. S. health policy and access to care. Health Services Los Angeles County,
Sultan, B. The domestic and international ethical debate on rationing care of illegal immigrants.
Skerry, P. Splitting the difference on illegal immigration. National Affairs.
Redding, S., Conrey, E., Porter, K., Paulson, J., Hughes, K., & Redding, M. (2015). Pathways community care coordination in low birth weight prevention. Maternal and Child Health Journal, 19, 3, 643-650.
Galewitz, P. How undocumented immigrants sometimes receive medicaid treatment. PBS Newshour. http://www.pbs.org/newshour/rundown/how-undocumented-immigrants-sometimes-receive-medicaid-treatment/ February 13, 2013.
“ROC M. D. Affordable Health Care For All,” http://rocunited.org/our-work/membership-leadership-development/roc-md/.
Gorman, A. L. A. program offers healthcare for illegal restaurant workers. Los Angeles Times. May 03, 2012.
Tavernise, S. (2015, Mar 23, 2015). Ounce of prevention: Health care systems try to cut costs by aiding poor. New York Times.
Graves, S. Senate bill 4-health center for all-set for first hearing. California Budget and Policy Center http://calbudgetcenter.org/blog/senate-bill-4-health-care-for-all-set-for-first-hearing/ April 14, 2015.
IOM (Institute of Medicine). (2009). America’s uninsured crisis: Consequences for health and health care. Washington, DC: The National Academies Press.
Long, S., Karpman, M., Kenney, G., Zuckerman, S., Wissoker, D., Shartzer, A., and Hempstead, N. (March 2015). Taking stock: Gains in health insurance coverage under the ACA as of March 2015. Washington, DC: Urban Institute.
Chilton, J. (2014, Jan 27). "Caught in coverage gaps". Wyoming Tribune – Eagle.
Garfield, R., Damico, A., Stephens, J., & Rouhani, S. (4/17/2015). The coverage gap: Uninsured poor adults in states that do not expand Medicaid – an update. Menlo Park, CA: The Henry J. Kaiser Family Foundation.
Long, S., Shartzer, A., & and Politi, M. (October 2014). Low levels of self-reported literacy and numeracy create barriers to obtaining and using health insurance coverage. Washington, DC: Urban Institute.
Chen J, Mullins CD, Novak P, Thomas SB. (2015). Personalized strategies to activate and Empower Patients in Health Care and reduce health disparities. Health Education and Behavio.
DeVries, A., Li, C., Sridhar, G., Hummel, J., Breidbart, S., & Barron, J. (2012). Impact of medical homes on quality, healthcare utilization, and costs.. American Journal of Managed Care, 18 (9), 534-44.
Adepoju, O., Preston, M., & Gonzales, G. (2015). Health care disparities in the Post–Affordable Care Act era. American Journal of Public Health,, e1-e3. [Epub ahead of print]. doi:-10.2105/AJPH.2015.302611
Galbraith, A., Ross-Degnan, D. Soumerai, S., B., Rosenthal, M., B., Gay, C., & Lieu, T., A. (2011). Nearly half of families in high-deductible health plans whose members have chronic conditions face substantial financial burden. Health Affairs, 30 (2), 322-331. doi:10.1377/hlthaff.2010.0584.
Oberlander, J. (2014). Between liberal aspirations and market forces: Obamacare's precarious balancing act. Journal of Law, Medicine & Ethics, 42 (4), 431-441. doi:10.1111/jlme.12166.
Reiss, S., Ross-Degnan, D., Zhang, F., Soumerai, S., Zaslavsky, A. M., Wharam, J. F. (October, 2011) Health Serv Res. 2011 Oct; 46 (5): 1382–1401. doi: 10.1111/j.1475-6773.2011.01252.x.
Lave, J. R., Men, A., Day, B. T., Wang, W., & Zhang, Y. (2011). Employee choice of a high-deductible health plan across multiple employers. Health Services Research, 46 (1), 138-154. doi:10.1111/j.1475-6773.2010.01167.x.
Borah, B. J., Burns, M. E., & Shah, N. D. (2011). Assessing the impact of high deductible health plans on health-care utilization and cost: A changes-in-changes approach. Health Economics, 20 (9), 1025-1042. doi:10.1002/hec.1757.
Levin, S. (2011). Acknowledging the importance of BAI accounts. Hfm (Healthcare Financial Management), 65 (9), 90.