Healthcare Overhaul

[Fish]

Un-insured call 911 regardless, and then don't pay us or the hospital. There is a difference between borrowed debt and Medical Debt. And a lot fo people choose to not pay and never do, since they will never be denied treatment regardless.

 

[Shishkabob]

On the EMS front, I see one of two things happening:


More people will have insurance, so either transport rates will go down since more transports are being reimbursed, OR transport rates will state the same even with more reimbursements, and the money will go back to the system, HOPEFULLY in the form of higher Paramedic pay!


Currently my agency collects on about 1/3 of transports. Since about 90% of the country is to have some form of insurance, conservatively I see about 50-60% of transports being reimbursed. More money for me?!

 

[medicsb]

Currently my agency collects on about 1/3 of transports. Since about 90% of the country is to have some form of insurance, conservatively I see about 50-60% of transports being reimbursed. More money for me?!

If reimbursement increases, expect the increased revenue to be passed on to anyone but the employee. Again, Massachusetts has a very similar set-up and I don't think anyone there has gotten increased pay due to increased reimbursement (assuming it has occurred).

 

[Shishkabob]

If reimbursement increases, expect the increased revenue to be passed on to anyone but the employee. Again, Massachusetts has a very similar set-up and I don't think anyone there has gotten increased pay due to increased reimbursement (assuming it has occurred).

Public/government agency. Not like we have shareholders or send money back to the cities and their coffers.

Hence only one of 2 things can happen: Lower costs for transport, or money gets sent right back in to the system and its employees.

 

[CANDawg]

Public/government agency. Not like we have shareholders or send money back to the cities and their coffers.

Hence only one of 2 things can happen: Lower costs for transport, or money gets sent right back in to the system and its employees.

Actually, it can easily go back into general revenue for the municipal government you work for. Unfortunately, this is more likely.

 

[Shishkabob]

Actually, it can easily go back into general revenue for the municipal government you work for. Unfortunately, this is more likely.

With how this agency is set up, no it can't.


Again, those 2 options I outlined are the only 2 possibilities: Cheaper transport fees, or back in to the agency some how.

 

[Aidey]

Please, expand on why these will occur.

Presumably more people will have access to a primary care MD or such and not require ER visits. However, this was supposed to happen with HMO"s, and we can see where corporate greed sent that. (My spouse worked for Foundation Health, so the "greed" opinion is first-hand).


We had a knock-down drag out about "Obamacare" in an earlier thread I started.

EDIT: I predict Florida will defy the national mandate.

Folks, we have a winner!

 

[JPINFV]

Medics=plural of medic
EMT's="EMT is" or denotes ownership by an EMT
EMTs=plural of EMT

This is the intertubes. Any grammar nazi posting regarding apostrophes requires the Bob the Angry Flower comic.

 

[JPINFV]

Currently my agency collects on about 1/3 of transports. Since about 90% of the country is to have some form of insurance, conservatively I see about 50-60% of transports being reimbursed. More money for me?!

You're assuming that just because the rate of transports being reimbursed means that the reimbursement per transport is going to stay the same. I'm going to predict that, while more transports are going to be reimbursed, the size of the population saying, "You can't bill me, I've got a government card" is going to increase, and the reimbursement per transport is going to go down, especially government reimbursement.

After all, why pay the taxi driver more?

 

[Tigger]

Probably the best place to look to get an idea of how the ACA will affect EMS is to look to Massachusetts, which has a healthcare system on which the ACA is based. Doesn't seem like much has changed there, even for EDs.

Granted I was not working before our system was implemented, but I bet anyone would be hard pressed to come up with any significant changes as a result of the passing of that legislation. MassHealth (state insurance for those without HMOs) pays by far the lowest reimbursement rate of all, including Medicare. Many of my scheduled patients use MassHealth in conjunction with an HMO or Medicare to pay for their transports and treatments, I imagine this may also occur with the ACA which may therefore increase reimbursements to private companies. Admittededly I do not have a great grasp of the system, however I've never transported any 911 patient or psych hold without insurance so it would seem that the law is working to an extent (obviously n=1 holds here).

 

[DPM]

FLorida has already been defying it. And Rush Limbaugh says he'll go expat if it goes into effect. Of course he can afford to be "self-insured".

And if he does he'll probably end up somewhere with public healthcare...

 

[whizkid1]

Not sure how it will turn out,wait and see I guess.

 

[bstone]

Not sure how it will turn out,wait and see I guess.

That's not a bad attitude. This has never been done before in this country (except for in MA, so a much smaller scale) but if MA is the model then it will be a success.

 

[Streetmedic7]

Cash on Delivery

It has been discused, in my state, that an ER pt who is uninsured and doesn't have an "emergent" chief complaint plops down $250 at check in. If this goes through, uninsured "taxi rides" to the ER might drop.

 

[JPINFV]

It has been discused, in my state, that an ER pt who is uninsured and doesn't have an "emergent" chief complaint plops down $250 at check in. If this goes through, uninsured "taxi rides" to the ER might drop.

$250 before the medical screening examination? Looks like an EMTALA violation waiting to happen.

 

[Veneficus]

$250 before the medical screening examination? Looks like an EMTALA violation waiting to happen.

I know some places triage people to attached fast tracks or urgent cares, so it might not exactly be a violation.

These same facilities usually charge a prior copay if the "patient" refuses to go to fast track or urgent care.