Does that work better in your area than in the Denver area? At the start of our current divert crisis, we were calling zone master hospitals and nobody on the hospital end (other than Denver Health) had any idea what we were talking about. We recently started a protocol where if more than 4 midtown hospitals are on divert our dispatch assigns destinations. It's worked infinitely better.
Probably yes it’s more suited to here than Denver. We only have two health networks and a total of four real hospitals in El Paso county, along with a non-designated ED that’s a step up from an freestanding as well as an Army hospital. The largest (Memorial Central) is in charge of the zone master and the other three hospitals are very familiar with it and don’t give the crews any issue. It also helps that we have unified medical direction across both health systems with multiple docs from each, they’re the ones that can push this and iron out kinks. Zone master utilizations are reviewed by medical direction monthly as well to make sure no one is “cheating.”
An overcrowded ED filled with uninsured frequent flyers is not a revenue generator for a hospital - quite the opposite.
States help to reimburse for uninsured patients, as well as tax write offs for expenses. While not necessarily profit, it's not a total loss.
In the grand scheme of things, I'm sure those patients generate revenue in the form of some sort of government subsidy to reimburse them for taking care of uninsured patients.
and
There is some reimbursement (charity care for the uninsured, but for undocumented or homeless, it's usually a writeoff), but more often than not, inner city ERs run in the red... all the time. Not only that, but often the revenue generated doesn't always cover the costs of the services provide, but they are legally required to provide the life saving interventions and assessments, regardless of the ability to pay. They (like EMS) consistently lose money, because they are required to provide services, with no guarantee of ever getting paid. In the EMS world, it's the interfacility transports that tend to generate the most profit and offset 911 losses, while in the hospitals, it's the more profitable departments, such as those listed below:
www.healthgrades.com
www.ems1.com
And I'm saying it's smoke and mirrors.and
There is some reimbursement (charity care for the uninsured, but for undocumented or homeless, it's usually a writeoff), but more often than not, inner city ERs run in the red... all the time. Not only that, but often the revenue generated doesn't always cover the costs of the services provide, but they are legally required to provide the life saving interventions and assessments, regardless of the ability to pay. They (like EMS) consistently lose money, because they are required to provide services, with no guarantee of ever getting paid. In the EMS world, it's the interfacility transports that tend to generate the most profit and offset 911 losses, while in the hospitals, it's the more profitable departments, such as those listed below:
10 Physician Specialties That Drive the Most Revenue for Hospitals
Hospital revenue from physicians had been increasing steadily prior to the COVID-19 pandemic. Find out which specialties ranked highest in 2019.<br>
I don't pretend to know everything about hospital budgets or operations, but I do know that some departments historically lose money (ER and trauma come to mind), while others are cash cows, and the reason hospitals continue to operate those money losing departments is those losses are offset by the consistent gains from the profitable departments.
There is a difference between saying a hospital is running in the red and saying that one of their major departments is running in the red. Obviously there could be exceptions, but ER's that are attached to hospitals are definitely not net revenue generators in most cases.
Off-site part of the hospital system, and yes they are all placed in "strategic areas" (i.e. not ghetto).
Look, the point here is that it isn't any financial incentive to having an overcrowded ER with long wait times. ED care is expensive to provide, a large proportion of those patients are uninsured, the all important Press-Ganey scores suffer, and no one wants to work there.
Didn’t mean to come off as a conspiracy theorist, I was merely injecting that hospitals generate an unfathomable amount of money each year. The homeless drunks with no insurance aren’t bankrupting anyone..
And no one ever suggested that they were. This whole line of discussion was a response to the idea that hospitals somehow want their EDs to be overcrowded because they somehow profit from long wait times.
Ah, i thought we were past that part of the thread, I guess I was responding to what was a tangential side conversation..
How much do you think hospitals are reimbursed for uninsured patients? And what is your definition of a 'total loss'? And who ultimately pays?(hint...property owners in the county for starters...) Whatever bones the county or state throw the hospitals in the form of Medicaid or Medicare, or worse, some kind of local subsidy, it's a pitiful fraction of what the actual per patient cost of maintaining a 24/365 ER. Reimbursement for what is provided is abysmal at best. But it's the system we have and the shortfall is made up in other areas...but the ER ain't that...
Ha...generate? No Bro, they don't generate anything...they collect. And that from people with benefits that their employers provide which offsets the homeless drunks with no insurance. That's built into the system. You are providing those dollars. And folks can say what they want about healthcare delivery in the US but you can have same day service for your hot gall bladder here instead of going home and waiting for 3 weeks like you would in other systems.
Isn't that the truth. Nothing keeps me at work late or gets me being called back in more often than a damn lap chole.
Generate, collect, tomato, tomato..