President's Letter
Charles C. Scott, MD, Phd, FACEP
Day by day, our jobs are more challenging, less resourced, and the safety net is thin. Surge capacity in Arkansas is decreasing, our hospitals fill up and spill out into the waiting room, and our communities are unaware of how often we are on disaster medicine footing. Need often outstretches resources, especially in smaller, rural states like Arkansas. This quarter, I would like to address a couple of issues, billing and increasing violence in our Departments. My transition to leadership roles has highlighted that we are in almost a solely reactive an environment. Small tweaks and volatile responses are not going to work. We need to re-think how we deliver care and engage. Being actively involved is tiring and uncomfortable, being irrelevant is much, much worse.
Billing Issues
Healthcare continues to become more complex in the administration and the only assured outcome is change. As a College, we have lost the battle with the insurance companies on “surprise billing” simply through the traction of the phrase. The insurance companies are still making plenty of money while issuing policies with deductibles that can be a quarter or a half of the income of people they cover. I am anyone working for an Emergency Medicine Staffing company has received emails about the current proposals in Congress because if they pass, our ability to be compensated fairly will diminish substantially. I would encourage you to contact your Federal Representative, as well as Senators. I will leave a summary done by Dr. Friedman and links should you desire to help:
“Congress has taken significant steps in moving legislation to address the issue of surprise billing and we appreciate their efforts. Our message continues to be that if not done right, legislation to address surprise bills could result in a significant over-reach of government authority into physician practices, giving a significant leg up to insurance companies that could potentially disrupt the entire healthcare system. At risk to you is your livelihood as a physician (both in terms of sharp reductions in salaries and reimbursement expected, and reducing opportunities on where you can practice), and continued access to quality care for your patients.
While ACEP and the majority of health care stakeholder groups support Congress efforts to solve the issue of surprise billing, we strongly oppose a "bench-marking" approach passed in House and Senate legislation that caps reimbursement for out-of-network care at the median in-network rate for that geographic area. This federal rate-setting approach not only increases the insurers' advantage over physicians but also does not taken into consideration the impact on patients. Without an adequate independent dispute resolution (IDR) process, these proposals will also have a ripple effect on in-network rates and will make it especially difficult for hospitals in under-served and rural areas to keep their emergency departments staffed and open.
During the congressional recess, we are asking you to continue to advocate for a more level playing field that also recognizes the unique nature of emergency care.”
The following should also be helpful on this issue:
- Here is an easy link to auto-populate a template email to send to your Rep/Senator
- Here is a video link to the ACEP Townhall if you'd like to watch it
- Forbes article on how IDR is a better solution than benchmarking
- Here is a blog which breaks down how benchmarking will gut EM reimbursement
- Here is information about Deleterious Effects of Surprise billing reform
- Here is information about Tampa Bay Times op-ed on surprise billing
Violence in the Emergency Department
As we have all witnessed our nurses and techs getting verbally abused and physically assaulted, I think we should advocate to quit accepting the assault as part of the job. I have been in meetings with administrators who have not touched a patient in years who think it is tolerable for a patient to take a swing or spit on a healthcare worker because they are psychotic or altered. At the same time, how many of us are actively encouraged to report acts of violence against healthcare workers. We need to advocate in Arkansas for similar bill that has been proposed in Oregon.
From Craig Price, CAE, ACEP Senior Director, Policy and Finance: In Oregon, a bill introduced on behalf of the Oregon Nurses Association and supported by Oregon ACEP, was passed that will protect the jobs of health care workers who file reports of violence and require hospitals to conduct a comprehensive safety and security evaluation to identify factors that could contribute to the occurrence of violent acts.”
Lets keep up to date about whats happening state wide in Arkansas. If you hear of anything before I do, please share it with the chapter.
Arkansas Chapter Events
Don't forget about our upcoming dinner at ACEP19 in Denver and the Chapter Annual Meeting that will be held in Little Rock. More information can be found in the next article. Please don't forget to RSVP with our Adriana, our Chapter Executive. I look forward to catching up with all of you at one or all of these events!
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