They are close to the breaking point.
A new study reveals that emergency rooms (ERs) in the United States are nearing a breaking point, leading to long wait times and delays in providing care. According to the research by RAND, ERs are increasingly tasked with providing services far beyond emergency care, but with fewer resources and less funding. The report highlights the urgent need for action to sustain these critical healthcare services that communities rely on during times of crisis.
The study notes that under federal law, all patients who arrive at an ER must be treated, regardless of their ability to pay. While ER visits declined during the COVID-19 pandemic due to restrictions, they are now returning to pre-pandemic levels. Additionally, patients are arriving with more complex medical issues, including chronic conditions, injuries, and mental health challenges. This increases the time doctors must spend with each patient, contributing to overcrowding and longer wait times, which can lead to frustration and tension between patients and staff.
At the same time, payments to ER doctors have decreased. Between 2018 and 2022, Medicare and Medicaid payments dropped by 3.8%, and payments from private insurers fell even more, with in-network visits dropping by 11% and out-of-network visits by 48%. This decrease in compensation is largely due to insurers and patients underpaying or denying payment for substantial portions of the costs, leaving ER doctors to handle more work for less pay, which raises the risk of burnout.
RAND’s report warns that unless these issues are addressed, there is a growing risk of ERs closing, an increase in the departure of healthcare workers, and even longer wait times for patients. The researchers suggest that a new payment system is needed to adequately compensate ERs for services such as mental health assessments, disease screenings, and care during mass casualty events. They also recommend expanding Medicaid payments for hospitals that serve uninsured populations and using federal funds to support public health services provided in ERs, such as vaccinations.
The report concludes that while no single solution fits all emergency departments or regions, a variety of recommendations can be tailored to different healthcare contexts to ensure that ERs can continue to function effectively and provide timely care to those in need.
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