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Tag Archives: value based purchasing
How Much Is the Nation Spending on ER Care? Wrong Question
Recently, Drs. Lee, Schuur, and Zink published an article in Annals of Emergency Medicine that detailed three different approaches to estimating the percentage of total national health care costs that were expended for emergency department care. The statement in this article that most health care journalists have picked up on is related to the authors’ assertion that spending on ER care could amount to as much as 10% of national health care budget. This clashes significantly with … Continue reading
‘Choosing Wisely’ Laying the Groundwork for Denial of Coverage
When the American College of Emergency Physicians (ACEP) decided not to join the Choosing Wisely campaign, I was among those who expressed disappointment with this decision, in part because I have long been a proponent of efforts to encourage more cost-effective care in the ED. In fact I had already independently done a significant amount of work in the development of such strategies. I recognized that there were legitimate concerns about participation in this campaign, … Continue reading
Compensating Emergency Physicians: If Not Fee-for-Service, What?
The push for payment reform in US health care is getting a great deal of support from every corner, and this will impact compensation for emergency physicians just as it will for nearly every specialty. Nearly everyone believes that our fee-for-service reimbursement system results in too much care for too little benefit. The perception that preventative and primary health care services are undercompensated, and procedural services to rescue failing health are overcompensated, seems to be … Continue reading
Cost Effective Care in the ED from the Patient’s Perspective
“Hey, John, how’s it goin’?” “Hi, Carl, better as you can see.” “Yea, looks like your cough has improved a lot. Jennifer told us you were headed to the ER after the game.” “Yep, Dr. Phillip’s office closes at 3 on Friday, and all that coughing was just wearing me out, you know?” “So, what’d they do? You’ve been coughing for a couple a weeks. Did you get a chest x-ray?” “Nope” “They start … Continue reading
Cost Effective Care in the Emergency Department – Developing Meaningful Strategies
Emergency physicians, and all other health care providers, are going to have to develop and adopt meaningful and responsible strategies to reduce the cost of care in our country, regardless of the outcome of the next election. The American College of Emergency Physicians has chosen to bypass the Choosing Wisely Campaign as insufficiently rigorous, and the College has some legitimate concerns. However, this simply means that the College must commit to a course that yields … Continue reading