Emergency Departments Losses Increase in 2002, CMA Report Finds

CAL/AAEM News Service calaaem_news at yahoo.com
Sun Oct 3 20:11:59 PDT 2004


Emergency Departments Losses Increase in 2002, CMA Report Finds

September 22, 2004

 
Hospitals in the state lost $460 million in emergency department care in fiscal
year 2002, according to a California Medical Association report issued Tuesday,
the Fresno Bee reports (Aleman-Padilla, Fresno Bee, 9/22). Researchers studied
data compiled by the Office of Statewide Health Planning and Development and
found that physicians in FY 2002 reported $175 million in unreimbursed ED care.
The report shows that doctors' and hospitals' losses increased by 18% between
FY 2000-2001 and FY 2001-2002 (San Francisco Chronicle, 9/22). In FY 2001,
hospital ED losses were $390 million (Fresno Bee, 9/22).

Researchers also found that 28 EDs in the state have closed since 2000. ED
costs "varied widely" statewide, with Los Angeles County hospitals accounting
for nearly one-third of the state's total ED losses, the Chronicle reports (San
Francisco Chronicle, 9/22). Los Angeles County EDs last year lost $143 million.
Almost 80% of EDs in the state reported a financial loss, with an average loss
of $80 per patient (Nguyen, AP/Contra Costa Times, 9/22).

CMA officials attribute the losses in part to low reimbursement rates from HMOs
and Medi-Cal, the Bee reports (Fresno Bee, 9/22). According to the Chronicle,
the costs of treating the uninsured also contributed to ED losses.


Study Conflicts

CMA's report is not consistent with findings from a June 2003 report by the
California HealthCare Foundation and the University of Southern California
indicating that EDs can generate profits for hospitals by increasing admissions
in other hospital departments and creating demand for additional care, the
Chronicle reports.

Glenn Melnick, author of the CHCF-USC study, said the CMA report does not
consider revenue from hospital admissions. He said, "If (hospitals) are in
financial crisis, it's not necessarily attributable to only the emergency
department," adding, "It's generally attributable to the fact they're losing
money on the inpatient side" (San Francisco Chronicle, 9/22).


Proposition 67

The report comes as CMA officials are seeking support for Proposition 67, an
initiative on the Nov. 2 statewide ballot that would provide $500 million
annually for hospitals, clinics and EDs by adding a 3% surcharge on telephone
service, except for cellular and business telephone lines. However, CMA has
said that the measure is a "quick fix" and will not solve all cost problems in
the long term, the AP/ Times reports (AP/Contra Costa Times, 9/22).


Response

CMA CEO Jack Lewin, said, "We face an unraveling of our health care system"
(San Francisco Chronicle, 9/22). He added, "We have a crisis in California that
we're trying to get across to our legislators."

S. Daniel Higgins, an ED physician and president of the Los Angeles County
Medical Association, said, "No businesses can survive these conditions. Our
widgets are people, and they're going to be get discarded if we don't fix this
problem" (AP/Contra Costa Times, 9/22).

Kelley Sanchez, a spokesperson for Saint Agnes Medical Center -- one of the few
hospitals in the state with a profitable ED -- also noted that state mandated
nurse-to-patient ratios combined with a nursing shortage is adding significant
cost (Fresno Bee, 9/22).


Broadcast Coverage

KQED's "The California Report" on Wednesday will examine the CMA report (Cohen,
"The California Report," KQED, 9/22). The complete segment will be available
online in RealPlayer after the broadcast.

Additional information on Proposition 67 is available online at
http://www.healthvote2004.org/67/emergencycare.php?pid=67


Source: California Healthline (www.californiahealthline.org) 


=====
Cyrus Shahpar & Brian Potts 
Managing Editors, CAL/AAEM News Service 
UC-Irvine



		
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