The Financial Impact of Uncompensated Care in the Emergency Department

Abstract

Prior to 1986, emergency department staff was both morally and ethically obligated to provide care that included the stabilization and treatment of all patients who presented to the emergency department, regardless of their ability to pay. In 1986, this moral and ethical obligation became federal law with the passage of the Emergency Medical Treatment and Labor Act (EMTALA), which required any patient coming to an emergency department be stabilized and treated regardless of their insurance status or ability to pay [1] [2]. Hospital emergency departments are a critical entry point into the American health care system. The patient population is a combination of the privately insured, including high deductible health plans, the uninsured, and the underinsured. Although emergency treatment is covered under EMTALA, hospitals are left to deal with the bills accumulated from non-emergent daily medical care. The increase in volume places tremendous burden on hospital emergency departments, with high overhead and fixed costs. Many facilities cannot keep up with costs and are forced into bankruptcy, leading to overcrowding in nearby hospitals. More thought must be placed on how hospitals can bear the burden of uncompensated care. Access to care is not enough; it's crucial that care be affordable. Addressing uncompensated care in the emergency department can be done successfully. The staff is proficient in saving lives, now they must learn to put the same effort into saving money.