Public Health Series: Crowding vs. Access - Effects of Upfront Emergency Room Payments

Public Health Series

Part III of IV

Over the past several years, issues of public health, e.g., community need and patient access to care, have become matters of concern and contentious topics leading to significant political debate. HC Topics' four-part Public Health Series has addressed, in past issues, changing areas of public health, including: healthcare nomenclature in "The New Language of Healthcare;" and, health disparities in "Health Disparities: What is Being Done?" The third article in this series examines the effects of a new hospital trend to distinguish and charge patients not in need of emergency care, in an attempt to ease waiting room crowding.

In 2011, approximately 80,000 prospective patients chose to leave emergency rooms without receiving treatment due to a new hospital cost-cutting policy that distinguishes and charges non-emergency patients who utilize emergency departments in lieu of routine healthcare providers, thereby potentially limiting access to healthcare for many individuals.

The IRS recently released an updated Form 990 for fiscal year 2011 which includes changes for exempt organizations, including joint ventures and investment partnerships. New compliance issues make significant changes with respect to organizations' financial reporting and governance requirements, as well as to the hospital reporting process.

The Agency for Healthcare Research and Quality (AHRQ) recently released its Quality Indicators Toolkit, a guideline that allows hospitals to assess their performance on quality measures and determine areas in need of improvement. These quality indicators will be incorporated into the Centers for Medicare and Medicaid Services Hospital Value-Based Purchasing Program beginning in fiscal year 2014, making the Toolkit a timely instrument for hospitals that need to improve their quality outcomes to achieve maximum reimbursement.

Part III of this retrospective examines the complex struggle among the stakeholders of a proposed Management Services Organization (MSO) in the decade of the 1990s, including the software selection committee, numerous potential vendors, and the committee's facilitator, resulting in an eventual cooperation. The struggle included the committee's reluctance to decide upon a matrix of various software application package requirements and the facilitator's necessary persuasion to bring about a final recommendation and plan.

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