Pay First at Emergency Room Deters Usage


Pay First at Emergency Room Deters Usage

Tuesday, February 21st, 2012 - 11:39
Tuesday, February 21, 2012 - 10:17
Patients with routine problems may be required to pay upfront forcing many to choose at the point of service.

Led by the for-profit chain behemoth HCA, hospitals are demanding payment before treatment of non-emergent care at ERs. According to Kaiser Health News and the Washington Post, approximately 80,000 people decided to forgo care when confronted with this choice at HCA owned hospitals. HCA asserts that they are in compliance with the law, conducting federally required screening of patients, and then attempting to divert them from the ER, where more acute care should be a priority.

Patient advocates argue otherwise. Led by groups like Families USA and emergency room physicians, many fear that those will simply forgo treatment in the event of an emergency or for those who leave the ER by not following up with another practitioner. Unfortunately, HCA and other hospitals do not appear to have created alternate arrangements to transition individuals into lower cost settings such as nearby urgent care facilities or outpatient centers.

While the opportunity to lower costs to the system exists, the number of patients is in question. The CDC claims the non-urgent suffering population is around 8% while a Health Affairs put the number closer to 27%. Furthermore, hospitals are particularly wary of treating patients in the ER that the law does not mandate in light of the pressures of reduced Medicaid reimbursements for non-urgent care, not to mention, dwindling resources for hospital uncompensated care funds.