Sunday, July 10, 2011

Hospitals Pre-Screening ER Patients to Improve Collections

Daytona Beach News Journal reported:

Inside the emergency room at Halifax Health, patients are being greeted by a new policy aimed at making sure they have a real medical emergency before they get treatment, a move aimed at saving money for the public hospital. 

Adults with the sniffles or a persistent cough -- or anything deemed to not be an emergency medical condition by a physician or a physician's assistant -- will be directed to an onsite health clinic that charges $48, or they will be given a list of community resources

Adults can still proceed with the emergency room visit, but only if they first pay their insurance co-pay or $350

Hospital emergency rooms are required to perform a medical screening exam on all patients who present.  Moving this review outside the doors of the ER seems a technicality.  How is prescreening different than a triage assessment?

The clear aim of this new policy is to improve collections, both in the ER and the urgent care clinic.  Note Halifax's spokesman is their Director of Patient Business and Financial Services.  It wasn't the ER Director or Medical Director of Emergency Care.  How do they feel about the new policy:  Cash up front or no care, except in true emergencies.  

Halifax officials say 34 percent of their bad debt is generated through their emergency rooms.

Earlier this month, Halifax board members heard about plans to wring some $5 million in savings out of the current Halifax system. Halifax officials said those savings will start with weeding out patients who don't reside in the taxing district and don't have a real emergency.

Patients from Southeast Volusia and West Volusia rang up about $7.7 million in costs that were never paid, with a substantial portion coming through the emergency room, Halifax officials estimate. 
Let me guess, Southeast and West Volusia are served by for-profit hospitals.  They know how to ask questions about patient responsibility that make people get up and leave the ER without care.

Times are tough for tax supported nonprofit community hospitals, such that they have to glean patient conditions and wallets, steering away those outside their tax district. 

Health reform means difficult times for the uninsured and safety net hospitals until 2014.  Congressional  & White House corporacrats renamed nonprofit community hospitals in PPACA.  They're now "private, tax exempt facilities."  To survive they must act like their for-profiteering counterparts, creating systems to "not get marked up" with no-pays.  How many safety net hospitals will make it until 2014?

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