States bribed by CMS to turn away Emergency Department Patients.
Bribing healthcare organizations to screen patients presenting to an emergency department is not the way to control healthcare costs. The Center for Medicare and Medicaid Services (CMS) is doing just that though. As part of a multi-million dollar incentive to the states it wants to divert patients with “non-emergency” medical problems away from local emergency departments and point them to other resources within the community. The goal is to decrease the cost associated with seeking care in that emergency department. This care is typically more expensive than care provided by clinics or a primary care provider.
Massachusetts is set to receive $4.6 million and Louisiana is going to obtain $3.7 million to put towards this effort. The hope is that additional funds will be available to pay providers in clinics to work weekends and evening hours to improve access to medical care, and thus help take the load of local emergency departments.
Those individuals without health insurance or primary care providers are a big factor in this plan that CMS had developed. Typically patients that present to an emergency department today with non-emergent care needs are there either due to lack of insurance, they have no personal provider, or if they do have insurance and a primary care provider, they are unable to make an appointment in a reasonable amount of time. Several times primary care providers direct their patients to go to the emergency department for routine healthcare needs.
I don’t see this plan as a way of dealing with emergency department crowding or a reasonable way of curtailing healthcare costs. If CMS wants to establish grants for the development of hospital based clinics with new construction and funding than that may be worth exploring, but this current incentive I think misses the mark. Additionally it raises questions about ethics and patient safety which may provide an impetus for potential litigation for hospitals.
About the Author
Mike Pringle is the author of Healthcare Today where he offers commentary and insight regarding today’s healthcare issues. Additionally he provides regular commentary for Red Scrubs and editorial content for Future Healthcare. He has over 20 years of nursing experience working both domestically and internationally. Mike has a Bachelor’s Degree in Nursing and a Masters Degree in Public Administration with a Healthcare emphasis. He specializes in both Emergency and Critical Care Nursing. He currently works at Falmouth Hospital as a Shift Manager for the emergency department.
