President proposes Medicare, Medicaid cuts / Study: Average ED wait up 36% / HHS faults emergency care

CAL/AAEM News Service calaaem_news at yahoo.com
Fri Feb 8 21:17:08 PST 2008


President proposes nearly $200 billion in Medicare, Medicaid cuts 

Source: American Hospital Association ( http://www.aha.org )
Date: February 4, 2008 


President Bush today proposed more than $182 billion in cuts to the Medicare program over
five years, $64 billion of which would come from the hospital inpatient update. His
fiscal year 2009 Department of Health and Human Services budget proposal would freeze
Medicare updates for inpatient and outpatient services, inpatient rehab facilities and
long-term care hospitals from 2009-2011, with updates of market-basket minus 0.65% each
year thereafter. Other Medicare reductions would include substantial cuts to indirect
medical education and hospital capital and disproportionate share payments, an overall
cut to hospitals through the establishment of a value-based purchasing program, and the
elimination of payments for so-called “never events.” The Medicaid program would be cut
by more than $17 billion over five years. AHA President and CEO Rich Umbdenstock said,
“Today’s budget blueprint would have a disastrous impact on the health care that millions
of patients and families depend on. Plain and simple: this plan slashes vital health
programs for the elderly and children and must be rejected.”

http://www.hhs.gov/budget/09budget/2009BudgetInBrief.pdf

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Study: Average ED wait up 36% 

Source: American Hospital Association ( http://www.aha.org )
Date: January 15, 2008 


Emergency department patients waited an average 30 minutes to see a physician in 2004,
eight minutes longer than in 1997, according to a study of U.S. ED visits published
online today by Health Affairs. Heart attack patients waited an average 20 minutes to see
an ED physician, 12 minutes longer than in 1997. The estimates are based on an analysis
of 90,000 visits to the ED by adults from 1997-2004, a period in which U.S. ED use
increased by 16.8 million visits annually. Caroline Steinberg, AHA vice president for
trends analysis, said, “Even as the demand for emergency care has increased, many
hospitals have closed - along with their EDs - due to pressures to reduce capacity. Today
99% of general acute care hospitals provide emergency services, the same portion as in
1990. There are just fewer of them, leading to increased patient loads. In addition, many
of the new hospitals that are opening - physician-owned, limited-service hospitals - are
choosing not to provide ED services.”

http://content.healthaffairs.org/cgi/content/abstract/hlthaff.27.2.w84v1

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HHS faults emergency care at physician-owned specialty hospitals

Source: American Hospital Association ( http://www.aha.org )
Date: February 4, 2008 


Only about half of physician-owned specialty hospitals have emergency departments, most
of which have only one bed, according to a new report by the Department of Health and
Human Services’ Office of Inspector General. Not all physician-owned specialty hospitals
always have nurses on duty and physicians on call or duty as required by Medicare, the
study found. Two-thirds of physician-owned specialty hospitals instruct staff to call
9-1-1 as part of their emergency response procedures, and less than one-third have
physicians on site at all times, the report adds. The OIG said the Centers for Medicare &
Medicaid Services should develop a system to identify and track physician-owned specialty
hospitals, and ensure that these hospitals meet Medicare staffing requirements and can
provide initial treatment of emergencies without relying on 9-1-1. In the report, CMS
concurred with the recommendations. AHA Executive Vice President Rick Pollack said the
report “illustrates yet another reason why Congress needs to take action in the best
interests of patients and ban physician self-referral to new limited-service hospitals
they own and operate.” 

Visit AHA News Now and its print version, AHA News, at http://www.ahanews.com/. Our
street address:

American Hospital Association
325 7th St. NW
Washington, DC 20004

Abid Mogannam &
Brian Potts MD, MBA
Managing Editors, CAL/AAEM News Service
University of California, Irvine

The CAL/AAEM Archives are available at: http://maillists.uci.edu/mailman/public/calaaem/



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