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2nd National Ranking of States for Emergency Medical Services to be Released

Tuesday, December 9, 2008 General News J E 4
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VERNON HILLS, Ill., Dec. 8 A national report card aimed atcalling attention to the support states provide to emergency patients will bereleased by the American College of Emergency Physicians (ACEP) this week onTuesday, December 9. Among other factors, it is expected to mention theimpact on Wisconsin hospital emergency departments from the state's extremelylow Medicaid payments for physician services.

"As we detailed in our own 'white paper' written earlier this year,Wisconsin's emergency physicians are seeing increases in the number ofMedicaid patients while at the same time receive payment for services that areamong the lowest in the nation," said Timothy Pavek, MD, president of theWisconsin Chapter of the American College of Emergency Physicians (WACEP)."This places extreme financial pressure on the emergency physicians in thestate at a time when the nation is facing major economic challenges."

ACEP's report card measures each state in five weighted categories:Access to Emergency Care (30 percent); Quality and Patient Safety Environment(20 percent); Medical Liability Environment (20 percent); Public Health andInjury Prevention (15 percent); and Disaster Preparedness (15 percent).

Wisconsin ranked 29th in the first report card issued by ACEP in 2006 withan overall grade of "C-minus."

Emergency physicians in Wisconsin have been calling attention to thechallenges facing the profession, and in particular the impact on access andavailability of care resulting from the underfunded Medicaid system. Dr.Pavek pointed out, "Unlike other medical providers, emergency physicians arerequired by federal law to see all patients who come to the emergencydepartment, regardless of whether they have insurance or their ability topay."

WACEP says that because Medicaid payments to emergency physicians do notadequately cover the cost of the care they provide, the increasing number ofMedicaid patients is draining resources available in the emergency department.This leads to overcrowding, increased waiting times, more frequent ambulancediversions (because an emergency department is too crowded to receive any morepatients), decreased availability of services provided by specialists, andultimately, the possible elimination of the emergency department by a hospitalaltogether.

According to WACEP, emergency department physicians bear a significantshare of the cost of providing care to Medicaid patients. For example, afterproviding hours of life-saving care to a Medicaid patient (such as for a heartattack, stroke, etc.), an emergency physician is paid only $37.40 for thehighest level of emergency care (CPT code 99285). This typically includes acomprehensive exam and complex medical decision making. The WisconsinMedicaid fee for this level of care has increased only two dollars in the past15 years while the Consumer Price Index during the same time went up more than42%.

Wisconsin emergency physicians also are deeply concerned about access tomental health and substance abuse treatment in the state. They noted that ashortage of long-term treatment facilities in the state puts an even greaterstrain on the state's emergency departments when these patients end up therefor acute care.

WACEP has called on the state to consider pegging Medicaid rates forcertain emergency services to the federal Medicare rates. Recognizing thelimitations on the state budget, Wisconsin emergency doctors have suggestedpossible funding sources for the proposal, including such things as increasedfines for drunk driving offenses, or traffic and seatbelt violations.

The Wisconsin Chapter of ACEP represents emergency physicians in the statethrough professional development, advocacy and public education programs.Some 370 physicians are members of the chapter.

SOURCE Wisconsin Chapter - American College of Emergency Physicians
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