Role of the Emergency Department Care Management Program

By Dr. Patricia Hines, Practice Lead, and Nancy Magee, Consultant

The Affordable Care Act (ACA) became law in January 2014 and extended access
to health insurance coverage to an estimated 30 million previously uninsured
people. Since that time, 11 million uninsured Americans have gained healthcare
insurance.

Many public policy analysts projected an increase in certain healthcare services,
emergency department visits being one of them. The American College of
Emergency Physicians (ACEP) recently released a report commissioned by the
Emergency Medicine Action Fund (EMAF). Findings suggest that 47% of healthcare
workers polled reported emergency room usage has increased slightly and 28%
reported that usage increased greatly. These increases have led to significant
financial, service and quality operational challenges. Additionally, an overwhelming
84% of emergency physicians report that psychiatric patients are being held
(“boarded”) in their emergency departments. This boarding practice has led to
violent behavior by distressed psychiatric patients, ED staff taxed by a complex
patient population and ED overcrowding, all of which could impact patient safety.

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