Does the Emergency Medical Treatment and Labor Act Affect Emergency Department Use?

McDonnell, William M.; Gee, Christopher; Mecham, Nancy; Dahl-Olsen, Jessica; Guenther, Elisabeth

doi:10.1016/j.jemermed.2012.01.042

Cited by 17 publications

(11 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Despite its importance, there has been relatively little published on EMTALA enforcement activities. The current literature on EMTALA is mostly limited to summaries and interpretations of the EMTALA statute, [3][4][5] reviews of case law, 6,7 assessments of patient and provider knowledge about EMTALA, 8,9 indirect measures of effect of the statute, [10][11][12][13] and limited descriptions of EMTALA enforcement before 2001. [14][15][16] We were unable to identify any recent original peer-reviewed longitudinal studies of epidemiology of EMTALA enforcement.…”

Section: Importancementioning

confidence: 99%

Enforcement of the Emergency Medical Treatment and Labor Act, 2005 to 2014

Terp

Seabury

Arora

et al. 2017

Annals of Emergency Medicine

View full text Add to dashboard Cite

We report the first national estimates of EMTALA enforcement activities in more than a decade. Although EMTALA investigations and citations were common at the hospital level, they were rare at the ED-visit level. CMS actively pursued EMTALA investigations and issued citations throughout the study period, with half of hospitals subject to EMTALA investigations and a quarter receiving a citation for EMTALA violation, although there was a declining trend in enforcement. Further investigation is needed to determine the effect of EMTALA on access to or quality of emergency care.

show abstract

Section: Importancementioning

confidence: 99%

Enforcement of the Emergency Medical Treatment and Labor Act, 2005 to 2014

Terp

Seabury

Arora

et al. 2017

Annals of Emergency Medicine

View full text Add to dashboard Cite

show abstract

“…If the medical issue is an emergency, the ED must treat and stabilize the patient without consideration of the patient's ability to pay for services. Some research has found that patient awareness of EMTALA is associated with greater ED use 7 and that patients prefer the ED to their primary care provider because it is more convenient 8,9 and does not require payment at the time of care. 10 In general, patients use the ED because of the perceived seriousness of their illness, because their doctor is not available, or because of a lack of access to other providers.…”

Section: Introductionmentioning

confidence: 99%

Systematic Review of Community Paramedicine and EMS Mobile Integrated Health Care Interventions in the United States

Gregg

Tutek

Leatherwood

et al. 2019

Population Health Management

View full text Add to dashboard Cite

Emergency medical services (EMS) in the United States are frequently used for nonurgent medical needs. Use of 911 and the emergency department (ED) for primary care-treatable conditions is expensive, inefficient, and undesirable for patients and providers. The objective is to describe the outcomes from community paramedicine (CP) and mobile integrated health care (MIH) interventions related to the Quadruple Aim. Three electronic databases were searched for peer-review literature on CP-MIH interventions in the United States. Eight articles reporting data from 7 interventions were included. Four studies reported high levels of patient satisfaction, and only 3 measured health outcomes. No study reported provider satisfaction measures. Reducing ED and inpatient utilization were the most common study outcomes, and programs generally were successful at reducing utilization. With reduced utilization, costs should be reduced; however, most studies did not quantify savings. Future studies should conduct economic analyses that not only compare the intervention to traditional EMS services, but also measure potential cost savings to the EMS agencies running the intervention. Most cost savings from reduced utilization will be to insurance companies and patients, but more efficient use of EMS agencies' resources could lead to cost savings that could offset intervention implementation costs. The other 3 aims (health, patient satisfaction, and provider satisfaction) were reported inconsistently in these studies and need to be addressed further. Given the small number of heterogeneous studies reviewed, the potential for CP-MIH interventions to comprehensively address the Quadruple Aim is still unclear, and more research on these programs is needed.

show abstract

“…Despite physicians’ and patients’ self‐reported familiarity with EMTALA, and public and professional concern about compliance, hospitals continue to violate the Act . In the first decade after it was passed, approximately a third of hospitals were investigated for EMTALA violations and, as of 2011, almost 30 years after the Act was passed, 40% of investigations still found violations…”

Section: Introductionmentioning

confidence: 99%

Complying with the Emergency Medical Treatment and Labor Act (EMTALA): Challenges and solutions

Hsuan

Horwitz

Ponce

et al. 2017

J of Healthc Risk Manag

View full text Add to dashboard Cite

The Emergency Medical Treatment and Labor Act (EMTALA), which requires Medicare-participating hospitals to provide emergency care to patients regardless of their ability to pay, plays an important role in protecting the uninsured. Yet many hospitals do not comply. This study examines the reasons for noncompliance and proposes solutions. We conducted 11 semistructured key informant interviews with hospitals, hospital associations, and patient safety organizations in the Centers for Medicare and Medicaid Services region with the highest number of EMTALA complaints filed. Respondents identified 5 main causes of noncompliance: financial incentives to avoid unprofitable patients, ignorance of EMTALA's requirements, high referral burden at hospitals receiving EMTALA transfer patients, reluctance to jeopardize relationships with transfer partners by reporting borderline EMTALA violations, and opposing priorities of hospitals and physicians. Respondents suggested 5 methods to improve compliance, including educating subspecialists about EMTALA, informally educating hospitals about borderline violations, and incorporating EMTALA-compliant processes into hospital operations such as by routing transfer requests through the emergency department. To improve compliance we suggest (1) more closely aligning Medicaid/Medicare payment policies with EMTALA, (2) amending the Act to permit informal mediation between hospitals about borderline violations, (3) increasing the hospital's role in ensuring EMTALA compliance, and (4) expanding the role of hospital associations.

show abstract

Does the Emergency Medical Treatment and Labor Act Affect Emergency Department Use?

Cited by 17 publications

References 17 publications

Enforcement of the Emergency Medical Treatment and Labor Act, 2005 to 2014

Enforcement of the Emergency Medical Treatment and Labor Act, 2005 to 2014

Systematic Review of Community Paramedicine and EMS Mobile Integrated Health Care Interventions in the United States

Complying with the Emergency Medical Treatment and Labor Act (EMTALA): Challenges and solutions

Contact Info

Product

Resources

About