Fewer Emergency Rooms Available as Need Rises and SF Attorney Sues Insurers for Hospital Underpayments

CAL/AAEM News Service calaaem.news.service1 at gmail.com
Wed Jun 8 16:17:07 PDT 2011


May 17, 2011
Fewer Emergency Rooms Available as Need Rises

The New York Times

By Roni Caryn Rabin
Hospital emergency rooms, particularly those serving the urban poor, are closing at an alarming rate even as emergency visits are rising, according to a report published on Tuesday.

Urban and suburban areas have lost a quarter of their hospital emergency departments over the last 20 years, according to the study, in The Journal of the American Medical Association. In 1990, there were 2,446 hospitalswith emergency departments in nonrural areas. That number dropped to 1,779 in 2009, even as the total number of emergency room visits nationwide increased by roughly 35 percent.

Emergency departments were most likely to have closed if they served large numbers of the poor, were at commercially operated hospitals, were in hospitals with skimpy profit margins or operated in highly competitive markets, the researchers found.

Although the study did not examine emergency care at the remaining facilities, the closings take a toll on the quality of care in all emergency rooms, said Dr. Renee Y. Hsia, an assistant professor of emergency medicine at the University of California, San Francisco, and the lead author of the study.

“Some people think, ‘As long as my emergency room isn’t closing, I feel O.K. and protected,’ ” said Dr. Hsia, whose research was financed by the Robert Wood Johnson Foundation. “But even if they don’t lose the E.R. in their own neighborhood, they do experience the effect of fewer emergency rooms — the waits get longer and longer, and people’s outcomes get worse.”
To read more, see the full article here.

May 25, 2011
San Francisco City attorney sues three medical insurers for hospital underpayments

AMA News
The San Francisco (CA) Appeal (5/26, McMenamin) reports, "San Francisco City Attorney Dennis Herrera has sued three medical insurers that he said have systematically underpaid San Francisco General Hospital and other public hospitals for emergency services given to those companies' policyholders." The civillawsuit names Blue Cross of California, Anthem Blue Cross Life and Health Insurance Company, and Health Net and "seeks an injunction to halt what Herrera's office said are the companies' unfair business practices, along with restitution for the alleged underpayments and civil penalties of up to $2,500 for each violation found of the state's business code."
The San Francisco (CA) Examiner (5/26, Burack) reports in its "Under Dome" blog that Herrera released a statement indicating that he is seeking money that he believes the hospital is entitled to. "The insurers we've sued are shortchanging public hospitals, and sticking taxpayers with the bill," Herrera said in the statement.Modern Healthcare (5/26, Vesely Subscription Publication) also covers the story.

Anna Parks &
Brian Potts MD, MBA
Managing Editors, CAL/AAEM News Service

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