Follow me
Category Archives: Previous Central Line Posts
State Medicaid Programs Tear Holes in the Emergency Care Safety Net
State governments have fallen into deep budget deficit holes, as we all know, and state legislators and policy makers are casting about for ways to dig themselves out. Many are climbing over the backs of those least able to fend for themselves in this troubled economy, since the poor have little clout and even less representation, now that the Supreme Court has given corporations and unions carte blanche to finance political campaigns up the political … Continue reading
Posted in Medicaid, Previous Central Line Posts
Tagged Emergency Care, Medicaid, prudent layperson
Leave a comment
Medicaid Managed Care Does Not Provide Better Access than FFS Medicaid for Non-emergency Care
The folks who run Medicaid Managed Care Plans often gripe about their enrollees using emergency departments for non-emergency care. And of course, they do, and probably more so than commercially insured enrollees. Most state and federal government regulators and legislators believe that capitation and managed care models for Medicaid can reduce the inappropriate use of ED services by Medicaid patients by incentives that encourage primary care providers in managed care organizations to increase access for … Continue reading
Posted in Medicaid, Previous Central Line Posts
Tagged deferral of ED care, Health Care Reform, Managed Care, Medicaid
Leave a comment
Much Ado About Very Little – the Deferral of ED Care Boondoggle
Boondoggle – a scheme that wastes time and money. Perhaps this is not the best way to describe the many efforts that are being made to try to keep patients with non-urgent problems from using the emergency department, but from where I sit, deferral of ED care is a cost-saving tactic that not only fails to deliver much in the way of cost savings, it also is a strategy that can be both risky and … Continue reading
Participation by Emergency Physicians in Compensation Driven Cost Containment Strategies
It strikes me that in developing payment reform related, compensation driven cost-containment strategies aimed at constraining the cost of emergency care, policy makers, emergency physicians, and health insurers should adhere to certain principles. ACEP should be at the forefront when it comes to establishing these principles, which I hope will be focused on protecting our patients first, and our specialty second. The concept and practice of ‘managed care’ has raised some very reasonable concerns about … Continue reading
Attribution and Emergency Medicine, a Payment Reform Conundrum
Several years ago, the medical director of the emergency department I was working in at the time decided to take a closer look at productivity amongst our physician and PA staff. In order to ensure that data on patients seen and visit times was being appropriately attributed to the treating physician or PA, we took a closer look at how the patient and the treating provider were linked in the hospital’s IT system (the data … Continue reading