ER-Forum Blog

How is emergency medicine doing this week?

Seemingly, there is always something in the news that affects emergency physicians and emergency medicine in general. Here's a summary of some of the stories circulating this week's news venues... 

American's health coverage has changed during the Recession. Surprised?

A new study published in the May 2010 issue of the Employee Benefits Research Institute examines some surprising and not-so-surprising changes in health coverage among workers during the recession which began in December 2007. The study's findings include:

• After the 2001 recession, the percentage of the non-elderly population with employment-based coverage continued a downward trend until mid-2005, when it flattened out at or slightly above 60 percent through 2007. The percentage of uninsured also flattened out, remaining at about 12.5 percent through 2007.
• The unemployment rate was as low as 4.4 percent in May 2007. By July 2009 it had reached 9.4 percent.
• The percentage of the non-elderly population where employment-based coverage was 61.3 percent in May 2007 and by July 2009 it was down to 58.2 percent.
• The uninsured rate was 12.3 percent in May 2007, and by July 2009 it was up to 16.4 percent.

New government office created to oversee insurance overhaul. Good news or....

A story posted this week on KevinMD.com sheds light on how a little known government department could have a big role in reforming health insurance.  As reported by the  government, the Department of Health and Human Services recently announced that it has created an Office of Consumer Information and Insurance Oversight to assist with implementation of the newly passed health insurance reform law.

Among the responsibilities overseen by this Office and its Divisions will include administering new high-risk pools and their funding. Putting in place new rules governing the insurance market and the rules regarding the percentage of revenues that health insurers will be required to spend on medical care. The collection and maintenance of comparative pricing data for the HHS health insurance website. The development of rules governing state-based health insurance exchanges, and overseeing their operations.  All sounds good, but as with anything our government does, it remains to be seen what the final verdict will be.

Insurance companies are refusing to pay for early discharges. Or are they?

The April 2010 issue of Annals of Emergency Medicine includes an article that attempts to debunk the theory that insurance companies are refusing payment for patients who leave the emergency department against medical advice. The authors reviewed 104 AMA discharges in a suburban hospital emergency department and queried 19 insurance companies including HMOs, PPOs, Medicare, Medicaid, and worker's compensation. Out of 104 AMA discharges, every visit was fully reimbursed by the insurance companies. Surprised? You're likely not alone.

Are on call ED physicians being compensated?

Being on call at a hospital's emergency department has been the price physicians paid for admitting privileges. But an article appearing in Medscape Today states that in 2009, hospitals compensated 61% of physicians who covered EDs. This is according to a survey by the Medical Group Management Association (MGMA).

Neurosurgeons commanded the top daily on-call rate of $1671. Family physicians who didn't deliver babies were at the bottom, earning $100 per day. Most physicians were paid daily stipends for ED call coverage; others received annual, monthly, or weekend stipends.

These findings appear in the MGMA publication Medical Directorship and On-Call Compensation: 2010 Report Based on 2009 Data. This report reflects the survey responses of 2924 on-call providers in 319 medical groups.

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