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2nd National Ranking of States for Emergency Medical Services to be Released
Date:12/8/2008

VERNON HILLS, Ill., Dec. 8 /PRNewswire/ -- A national report card aimed at calling attention to the support states provide to emergency patients will be released by the American College of Emergency Physicians (ACEP) this week on Tuesday, December 9. Among other factors, it is expected to mention the impact on Wisconsin hospital emergency departments from the state's extremely low Medicaid payments for physician services.

"As we detailed in our own 'white paper' written earlier this year, Wisconsin's emergency physicians are seeing increases in the number of Medicaid patients while at the same time receive payment for services that are among the lowest in the nation," said Timothy Pavek, MD, president of the Wisconsin Chapter of the American College of Emergency Physicians (WACEP). "This places extreme financial pressure on the emergency physicians in the state at a time when the nation is facing major economic challenges."

ACEP's report card measures each state in five weighted categories: Access to Emergency Care (30 percent); Quality and Patient Safety Environment (20 percent); Medical Liability Environment (20 percent); Public Health and Injury Prevention (15 percent); and Disaster Preparedness (15 percent).

Wisconsin ranked 29th in the first report card issued by ACEP in 2006 with an overall grade of "C-minus."

Emergency physicians in Wisconsin have been calling attention to the challenges facing the profession, and in particular the impact on access and availability of care resulting from the underfunded Medicaid system. Dr. Pavek pointed out, "Unlike other medical providers, emergency physicians are required by federal law to see all patients who come to the emergency department, regardless of whether they have insurance or their ability to pay."

WACEP says that because Medicaid payments to emergency physicians do not adequately cover the cost of the care they provide, the increasing number of Medicaid patients is draining resources available in the emergency department. This leads to overcrowding, increased waiting times, more frequent ambulance diversions (because an emergency department is too crowded to receive any more patients), decreased availability of services provided by specialists, and ultimately, the possible elimination of the emergency department by a hospital altogether.

According to WACEP, emergency department physicians bear a significant share of the cost of providing care to Medicaid patients. For example, after providing hours of life-saving care to a Medicaid patient (such as for a heart attack, stroke, etc.), an emergency physician is paid only $37.40 for the highest level of emergency care (CPT code 99285). This typically includes a comprehensive exam and complex medical decision making. The Wisconsin Medicaid fee for this level of care has increased only two dollars in the past 15 years while the Consumer Price Index during the same time went up more than 42%.

Wisconsin emergency physicians also are deeply concerned about access to mental health and substance abuse treatment in the state. They noted that a shortage of long-term treatment facilities in the state puts an even greater strain on the state's emergency departments when these patients end up there for acute care.

WACEP has called on the state to consider pegging Medicaid rates for certain emergency services to the federal Medicare rates. Recognizing the limitations on the state budget, Wisconsin emergency doctors have suggested possible funding sources for the proposal, including such things as increased fines for drunk driving offenses, or traffic and seatbelt violations.

The Wisconsin Chapter of ACEP represents emergency physicians in the state through professional development, advocacy and public education programs. Some 370 physicians are members of the chapter.


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SOURCE Wisconsin Chapter - American College of Emergency Physicians
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