| A model for improving uninsured children's access to health insurance via the emergency department. | |
| | |
MedLine Citation:
|
PMID: 19413165 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
A shift in commercially insured patients to publicly insured or uninsured status has caused an increase in emergency department (ED) visits for routine and nonemergent care. Meanwhile, hospitals struggle to compensate for decreasing reimbursements across all payer groups and increasing underwritten costs of care for the uninsured. Children represent a particularly vulnerable population and a substantial proportion of uninsured patients. In this study we assessed the efficacy and financial benefit of an insurance-referral program that is integrated into the routine pediatric ED admitting protocol of an academic hospital for the period 2004 to 2007. In this model, the ED of Stanford Hospital and Clinics acted as a referral agency to the San Mateo County Children's Health Initiative, a county coalition that carries out screening and enrollment assistance for public insurance. Referral from the ED was available 24 hours a day, and partnership with the county coalition negated the use of a hospital insurance-enrollment worker. Over the four-year study period, the referral program attained a successful linkage rate of 54.5 percent, which represents nearly 800 newly insured children. The vast majority (88.6 percent) of these pediatric patients were linked to Medicaid, which can reimburse retroactively for services rendered. For the academic hospital, this linkage rate resulted in $105,829.25 in insurance reimbursements and $658,559.97 deflected from bad-debt conversion. This pilot program is a sustainable, medically responsible model for linking uninsured children who need medical services with healthcare insurance. In addition, the program has the potential to yield financial return for the hospital. Similar models may be implemented in EDs across the United States. Healthcare managers who are seeking to alleviate the financial impact of care for the uninsured may find this model to be useful. |
| | |
Authors:
|
Colleen Acosta; Charles Dibble; Mary Giammona; N Ewen Wang |
Related Documents
:
|
10122895 - Information technology can improve healthcare quality. 20922325 - Analysis of the organizational aspects of a clinical emergency department: a study in a... 16431225 - Ultrasonography in community emergency departments in the united states: access to ultr... 10511495 - Compliance with universal precautions among emergency department personnel: implication... 17484365 - Significance of a level-2, "selective, secondary evacuation" hospital during a peripher... 22223815 - A hospital's adoption of information technology is associated with altered risks of hos... |
Publication Detail:
|
Type: Journal Article |
Journal Detail:
|
Title: Journal of healthcare management / American College of Healthcare Executives Volume: 54 ISSN: 1096-9012 ISO Abbreviation: J Healthc Manag Publication Date: 2009 Mar-Apr |
Date Detail:
|
Created Date: 2009-05-05 Completed Date: 2009-06-02 Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 9803529 Medline TA: J Healthc Manag Country: United States |
Other Details:
|
Languages: eng Pagination: 105-15; discussion 115-6 Citation Subset: H |
Affiliation:
|
Division of Emergency Medicine, Stanford University School of Medicine, Stanford, California, USA. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Adolescent Child Child Health Services Child, Preschool Community-Institutional Relations / economics Emergency Service, Hospital* Humans Insurance Coverage* Medically Uninsured* Models, Organizational Retrospective Studies |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Patient satisfaction: focusing on "excellent".
Next Document: Measuring the opportunity loss of time spent boarding admitted patients in the emergency department:...