Hospitals are treating an increasing number of uninsured patients, which can create a financial burden for the facilities. Here, James Parish, executive vice president of RWD Technologies' healthcare practice, discusses how hospitals can reduce the financial burdens created by the growing uninsured population.
Q: What problems do the increasing number of uninsured patients create for hospitals?
James Parish: The largest impact we are seeing as a result of this trend is that more uninsured people are using emergency departments, and as a result, a higher percentage of patients in the emergency department are unable to pay for their treatment, which negatively impacts hospital revenue.
Because most emergency departments tend to treat all patients that arrive, people who are presenting to emergency departments without insurance often do so because they cannot afford to see a primary care physician. The recent economic conditions are creating growing uninsured populations, which leads to emergency departments experiencing an increasing number of these patients. Unfortunately, at most hospitals, the demand for emergency services outpaces the facility’s capacity to provide services. This creates longer wait times for patients, which is particularly problematic because patients who are able to pay for services have the resources to leave and find another hospital that can treat them more efficiently.
Additionally, many hospitals are being forced to close their ER when it reaches capacity and divert patients to other hospitals. This is always negative since this action hurts both the reputation of hospitals and their revenue generation.
Q: What can hospitals do to best manage the growing number of uninsured patients presenting to the emergency department?
JP: Emergency departments must improve their processes so that they are able to treat patients more efficiently. Their goal needs to be to have a zero percent turn-away policy which will improve both their profitability and their reputation.
By becoming more efficient, these departments will be able to treat more people with the same amount of time and resources. This includes improvement of check-in processes, triage definitions, flow of patients, treatment activities and more. An ER can easily increase capacity by 10-30 percent with process improvements.
Q: What are some strategies that the organizations you work with use to improve their emergency department efficiency?
JP: There are two primary areas where emergency departments can see improvements through process efficiency. The first is the way they admit patients and the second is the flow of patients through the ER activities.
Emergency departments must better triage patients. They need to be seen at the front desk very quickly, and insurance should be checked upfront. This only takes a few seconds but helps ensure hospital reimbursement. Emergency department staff should also make it a priority to take blood pressure and temperature as soon as possible after a patient presents. Patients should be grouped into low-, medium- and high-need groups. Each patient group can be sent to a designated area in the emergency department and treated accordingly.
Additionally, hospitals can benefit from rearranging the layout of the department in order to improve the flow of the department. In most ERs, nothing is where anyone needs it to be. Even rearranging supplies so that they are located in convenient spots can save time.
Q: What kind of impact can hospitals expect if they enact these changes?
JP: Obviously, it can vary greatly, but some hospitals we have worked with have seen increases in capacity of 20-30 percent in their emergency departments within six months of starting to take action.
The key is that all emergency departments can make changes that will greatly increase their capacity, allowing them to treat more people at a lower cost.
Mr. Parish (jparish@rwd.com) consults with hospitals to address challenges in critical areas such as emergency department patient flow, perioperative services management, staff training and retention and core measure performance. Learn more about RWD Technologies’ healthcare practice.
Q: What problems do the increasing number of uninsured patients create for hospitals?
James Parish: The largest impact we are seeing as a result of this trend is that more uninsured people are using emergency departments, and as a result, a higher percentage of patients in the emergency department are unable to pay for their treatment, which negatively impacts hospital revenue.
Because most emergency departments tend to treat all patients that arrive, people who are presenting to emergency departments without insurance often do so because they cannot afford to see a primary care physician. The recent economic conditions are creating growing uninsured populations, which leads to emergency departments experiencing an increasing number of these patients. Unfortunately, at most hospitals, the demand for emergency services outpaces the facility’s capacity to provide services. This creates longer wait times for patients, which is particularly problematic because patients who are able to pay for services have the resources to leave and find another hospital that can treat them more efficiently.
Additionally, many hospitals are being forced to close their ER when it reaches capacity and divert patients to other hospitals. This is always negative since this action hurts both the reputation of hospitals and their revenue generation.
Q: What can hospitals do to best manage the growing number of uninsured patients presenting to the emergency department?
JP: Emergency departments must improve their processes so that they are able to treat patients more efficiently. Their goal needs to be to have a zero percent turn-away policy which will improve both their profitability and their reputation.
By becoming more efficient, these departments will be able to treat more people with the same amount of time and resources. This includes improvement of check-in processes, triage definitions, flow of patients, treatment activities and more. An ER can easily increase capacity by 10-30 percent with process improvements.
Q: What are some strategies that the organizations you work with use to improve their emergency department efficiency?
JP: There are two primary areas where emergency departments can see improvements through process efficiency. The first is the way they admit patients and the second is the flow of patients through the ER activities.
Emergency departments must better triage patients. They need to be seen at the front desk very quickly, and insurance should be checked upfront. This only takes a few seconds but helps ensure hospital reimbursement. Emergency department staff should also make it a priority to take blood pressure and temperature as soon as possible after a patient presents. Patients should be grouped into low-, medium- and high-need groups. Each patient group can be sent to a designated area in the emergency department and treated accordingly.
Additionally, hospitals can benefit from rearranging the layout of the department in order to improve the flow of the department. In most ERs, nothing is where anyone needs it to be. Even rearranging supplies so that they are located in convenient spots can save time.
Q: What kind of impact can hospitals expect if they enact these changes?
JP: Obviously, it can vary greatly, but some hospitals we have worked with have seen increases in capacity of 20-30 percent in their emergency departments within six months of starting to take action.
The key is that all emergency departments can make changes that will greatly increase their capacity, allowing them to treat more people at a lower cost.
Mr. Parish (jparish@rwd.com) consults with hospitals to address challenges in critical areas such as emergency department patient flow, perioperative services management, staff training and retention and core measure performance. Learn more about RWD Technologies’ healthcare practice.