The Influence of Medicare for All on Reimbursement for Emergency Care Treat-and-Release Visits.

Abstract:

STUDY OBJECTIVE:Single-payer health care is supported by most Americans, but the effect of single payer on any particular sector of the health care market has not been well explored. We examine the effect of 2 potential single-payer designs, Medicare for All and an alternative including Medicare and Medicaid, on total payments and out-of-pocket spending for treat-and-release emergency care (patients discharged after an emergency department [ED] visit). METHODS:We used the 2013 to 2016 Medical Expenditure Panel Survey to determine estimates of payments made for ED visits by insurance type, and the 2015 National Hospital Ambulatory Medical Care Survey to estimate the proportion of ED visits covered by each insurance type. RESULTS:We found that total payments were predicted to increase from $85.5 billion to $89.0 billion (range $81.3 to $99.8 billion) in the Medicare-only scenario and decrease to $79.4 billion (range $71.6 to $87.2 billion) under Medicare/Medicaid, whereas out-of-pocket costs were predicted to decrease from $116 per visit to $45 with Medicare and to $36 with Medicare/Medicaid. CONCLUSION:In this study of ED treat-and-release patients, a transition to a Medicare for All system may increase ED reimbursement and reduce consumer out-of-pocket costs, whereas a system that maintains Medicaid in addition to Medicare could reduce total payments for emergency care.

journal_name

Ann Emerg Med

authors

Pomerantz A,Burke R,Friedman A,Burke L,Wolfe R,Smulowitz P

doi

10.1016/j.annemergmed.2020.03.003

subject

Has Abstract

pub_date

2020-10-01 00:00:00

pages

454-458

issue

4

eissn

0196-0644

issn

1097-6760

pii

S0196-0644(20)30174-8

journal_volume

76

pub_type

杂志文章
  • Emergency department patients who leave without seeing a physician: the Toronto Hospital experience.

    abstract:STUDY OBJECTIVES:To determine why emergency department patients leave without being seen by a physician and whether they receive alternate medical care. DESIGN:A prospective, cross-sectional study of patients who left without being seen. Charts were reviewed for population demographics, presenting complaints, and clin...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章

    doi:10.1016/s0196-0644(94)70238-1

    authors: Fernandes CM,Daya MR,Barry S,Palmer N

    更新日期:1994-12-01 00:00:00

  • Can broad-range 16S ribosomal ribonucleic acid gene polymerase chain reactions improve the diagnosis of bacterial meningitis? A systematic review and meta-analysis.

    abstract:STUDY OBJECTIVE:We aim to evaluate the accuracy of the broad-range 16S polymerase chain reaction test in the diagnosis of bacterial meningitis through a systematic review and meta-analysis. METHODS:We searched MEDLINE, EMBASE, and the Cochrane Controlled Trials Registry, using the Medical Subject Headings terms "polym...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章,meta分析,评审

    doi:10.1016/j.annemergmed.2012.05.040

    authors: Srinivasan L,Pisapia JM,Shah SS,Halpern CH,Harris MC

    更新日期:2012-11-01 00:00:00

  • Outcome of patients experiencing cardiac arrest with carbon monoxide poisoning treated with hyperbaric oxygen.

    abstract:STUDY OBJECTIVE:We sought to examine the outcome of a subgroup of patients with extreme carbon monoxide (CO) poisoning, specifically those discovered in cardiac arrest, resuscitated, and subsequently treated with hyperbaric oxygen (HBO(2)). Opinions of hyperbaric medicine physicians regarding the treatment of such pati...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章

    doi:10.1067/mem.2001.115532

    authors: Hampson NB,Zmaeff JL

    更新日期:2001-07-01 00:00:00

  • Compliance with universal precautions in a university hospital emergency department.

    abstract::We investigated the compliance of emergency department health care workers with barrier precaution policies adapted from the Centers for Disease Control's "Recommendations for Prevention of HIV Transmission in Health-Care Settings." One hundred sixty-nine health care worker encounters with 97 patients were observed. O...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章

    doi:10.1016/s0196-0644(89)80522-0

    authors: Baraff LJ,Talan DA

    更新日期:1989-06-01 00:00:00

  • Outpatient treatment of deep venous thrombosis: a clinical care pathway managed by the emergency department.

    abstract:STUDY OBJECTIVE:We evaluate the effectiveness and safety of an outpatient clinical care pathway for the initial treatment of acute proximal lower-extremity deep venous thrombosis (DVT) with low molecular weight heparin (LMWH) managed by the emergency department of 2 affiliated community hospitals. METHODS:This observa...

    journal_title:Annals of emergency medicine

    pub_type: 临床试验,杂志文章

    doi:10.1067/mem.2001.113703

    authors: Vinson DR,Berman DA

    更新日期:2001-03-01 00:00:00

  • Extreme hypothermia and ventricular fibrillation.

    abstract::A 31-year-old white man with a core temperature of 60.8 F (16 C) and ventricular fibrillation was successfullly resuscitated using active core and external rewarming techniques. Rectal temperature at the time of reestablished electromechanical cardiac activity was 68 F (20 C), a temperature previously thought to be in...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章

    doi:10.1016/s0196-0644(80)80339-8

    authors: DaVee TS,Reineberg EJ

    更新日期:1980-02-01 00:00:00

  • Implications of conducting trend analyses of emergency department visits using publicly released masked design variables.

    abstract:STUDY OBJECTIVE:We examine whether using public National Hospital Ambulatory Medical Care Survey (NHAMCS) data with masked design variables produces different estimates, standard errors, and confidence intervals (CIs) for the temporal trend of overall and injury-related emergency department (ED) visits compared with us...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章

    doi:10.1016/j.annemergmed.2010.12.025

    authors: Zhu M,Chu H,Rice TM,Carter MW

    更新日期:2011-06-01 00:00:00

  • Effective discharge communication in the emergency department.

    abstract::Communication at discharge is an important part of high-quality emergency department (ED) care. This review describes the existing literature on patient understanding and implementation of discharge instructions, discusses previous interventions aimed at improving the discharge process, and recommends best practices a...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章,评审

    doi:10.1016/j.annemergmed.2011.10.023

    authors: Samuels-Kalow ME,Stack AM,Porter SC

    更新日期:2012-08-01 00:00:00

  • Safely directing patients to appropriate levels of care: guideline-driven triage in the emergency service.

    abstract:STUDY OBJECTIVE:We sought to develop and validate standardized clinical criteria to identify patients presenting to the emergency department whose care may be safely deferred to a later date in a nonemergency setting. METHODS:Using a modified Delphi process, a 17-member multidisciplinary physician panel developed expl...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章

    doi:10.1067/mem.2000.107003

    authors: Washington DL,Stevens CD,Shekelle PG,Baker DW,Fink A,Brook RH

    更新日期:2000-07-01 00:00:00

  • Electrical injuries in a pediatric emergency department.

    abstract:STUDY OBJECTIVE:To examine the spectrum of electrical injuries and develop guidelines for management. DESIGN:Retrospective review of charts compiled during a 6-year period (1988 through 1993). SETTING:Pediatric emergency department. PARTICIPANTS:Seventy-eight patients seen for electrical injuries. RESULTS:Fifty-fou...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章

    doi:10.1016/s0196-0644(95)70012-9

    authors: Garcia CT,Smith GA,Cohen DM,Fernandez K

    更新日期:1995-11-01 00:00:00

  • Gram's stain of peritoneal fluid is rarely helpful in the evaluation of the ascites patient.

    abstract:STUDY OBJECTIVE:We determine the sensitivity, specificity, and clinical utility of the Gram's stain of peritoneal fluid in patients undergoing paracentesis. METHODS:We conducted a retrospective chart review of all peritoneal fluid analyses in a 3-year period in an urban 3-hospital system. Peritoneal dialysis and diagn...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章

    doi:10.1016/j.annemergmed.2008.12.020

    authors: Chinnock B,Fox C,Hendey GW

    更新日期:2009-07-01 00:00:00

  • Coacaethylene levels in patients who test positive for cocaine.

    abstract:STUDY OBJECTIVE:To determine the presence of cocaethylene, an active metabolite of the combination of cocaine and ethanol, among trauma patients who test positive for cocaine. METHODS:We assembled a case series of 416 consecutive urban trauma center patients with major trauma. Urine was tested for the presence of the ...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章

    doi:10.1016/s0196-0644(96)70266-4

    authors: Brookoff D,Rotondo MF,Shaw LM,Campbell EA,Fields L

    更新日期:1996-03-01 00:00:00

  • Permanently imbedded subcutaneous acupuncture needles: radiographic appearance.

    abstract::During the evaluation of a victim of a motor vehicle accident, routine radiographs of the patient's cervical spine, chest, and pelvis revealed multiple radiopaque foreign bodies along his posterior neck, chest, abdomen, and pelvis. Repeat examination of the patient disclosed no evidence of foreign bodies. Further ques...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章

    doi:10.1016/s0196-0644(05)82986-5

    authors: Hollander JE,Dewitz A,Bowers S

    更新日期:1991-09-01 00:00:00

  • Ultrasound detection of ventricular fibrillation disguised as asystole.

    abstract::Ultrasonography in the emergency department is being used for many purposes, including the evaluation of patients with cardiac arrest. Ultrasound testing has been shown to be useful in such patients in determining the presence of true electromechanical dissociation and pericardial effusions. We report a case of ventri...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章

    doi:10.1016/s0196-0644(99)70372-0

    authors: Amaya SC,Langsam A

    更新日期:1999-03-01 00:00:00

  • Limitation on effectiveness of rapid defibrillation by emergency medical technicians in a rural setting.

    abstract::First-responding emergency medical technicians (EMTs) trained to defibrillate have been shown to increase survival from prehospital ventricular fibrillation (VF) almost fourfold in Washington's King County. Using Nebraska ambulance rescue run data from 1982 and published information relating ambulance response time to...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章

    doi:10.1016/s0196-0644(84)80331-5

    authors: Ornato JP,McNeill SE,Craren EJ,Nelson NM

    更新日期:1984-12-01 00:00:00

  • Hemodynamics and metabolic effects of fructose 1-6 diphosphate in ischemia and shock--experimental and clinical observations.

    abstract::Numerous interventions have been used to protect organ systems and cellular viability from the lethal injury accompanying hypoperfusion and ischemia. Some measures have been directed toward improving perfusion, while others have attempted to enhance the metabolic processes. Our work has focused for the most part on au...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章

    doi:10.1016/s0196-0644(86)80946-5

    authors: Markov AK

    更新日期:1986-12-01 00:00:00

  • Pediatric bacterial meningitis: is prior antibiotic therapy associated with an altered clinical presentation?

    abstract:STUDY HYPOTHESIS:The clinical features of children treated with oral antibiotics before the diagnosis of bacterial meningitis differ from those who receive no antibiotics. DESIGN:Retrospective case series. SETTING:University medical center. PARTICIPANTS:Two hundred fifty-eight children 24 months old or younger with ...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章

    doi:10.1016/s0196-0644(05)80149-0

    authors: Rothrock SG,Green SM,Wren J,Letai D,Daniel-Underwood L,Pillar E

    更新日期:1992-02-01 00:00:00

  • Experience with a mobile coronary care unit in Brisbane.

    abstract::We examined the performance of a hospital-based mobile coronary care unit staffed by emergency physicians, coronary care nurses, and ambulance personnel in a metropolitan setting (Brisbane, Australia). Our unit attended 2,260 calls during 18 months of operation. Standard dispatched ambulances arrived first to 78% of t...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章

    doi:10.1016/s0196-0644(89)80462-7

    authors: Bett JH

    更新日期:1989-09-01 00:00:00

  • A Video-Based, Case-Control Study of Factors Associated With Intraosseous Catheterization During Pediatric Resuscitation.

    abstract:STUDY OBJECTIVE:Factors associated with intraosseous (IO) catheterization are not well described. Our objective is to identify factors associated with the attempt and timing of IO catheterization in a pediatric emergency department (ED) resuscitation setting. METHODS:We completed a video-based, case-control study (1:3...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章

    doi:10.1016/j.annemergmed.2019.09.005

    authors: Lee SH,Frey M,Kerrey BT,Zhang Y,Byczkowski T,Geis GL

    更新日期:2020-06-01 00:00:00

  • Acute stroke: delays to presentation and emergency department evaluation.

    abstract:STUDY OBJECTIVE:To document prehospital and inhospital time intervals from stroke onset to emergency department evaluation and to identify factors associated with presentation to the ED within 3 hours of symptom onset, the current time window for thrombolytic therapy. METHODS:Patients admitted through the ED with a di...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章

    doi:10.1016/s0196-0644(99)70431-2

    authors: Kothari R,Jauch E,Broderick J,Brott T,Sauerbeck L,Khoury J,Liu T

    更新日期:1999-01-01 00:00:00

  • Electrolytes, BUN, creatinine: who's at risk?

    abstract::Electrolytes, BUN, and creatinine are some of the most frequently ordered laboratory tests. The use of these tests in emergency practice has not been studied critically, and few investigations of their use in other disciplines have been performed. A review of the available literature and an analysis of medical problem...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章,评审

    doi:10.1016/s0196-0644(86)80586-8

    authors: Checchio LM,Como AJ

    更新日期:1986-03-01 00:00:00

  • Sore throat: to culture or not to culture.

    abstract::The traditional use of the throat culture to guide treatment of potential streptococcal pharyngitis recently has been questioned because of the following facts: antibiotic therapy within the first 48 hours of illness reduces the severity and symptoms of streptococcal pharyngitis; more rapid treatment of streptococcal ...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章

    doi:10.1016/s0196-0644(86)80573-x

    authors: Hedges JR,Lowe RA

    更新日期:1986-03-01 00:00:00

  • Rapid flow rates for the resuscitation of hypovolemic shock.

    abstract::Nine dogs were hemorrhaged to approximately 40% of their blood volume and then were resuscitated with a crystalloid solution (Normosol) at various flow rates. Three study groups with three dogs in each group were resuscitated at 15 mL/min/kg (Group 1), 6 mL/min/kg (Group 2), and 4 mL/min/kg (Group 3). Central venous p...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章

    doi:10.1016/s0196-0644(85)80091-3

    authors: Dula DJ,Lutz P,Vogel MF,Weaver BN

    更新日期:1985-04-01 00:00:00

  • Risk of thromboembolism varies, depending on category of immobility in outpatients.

    abstract:STUDY OBJECTIVE:Immobility predisposes to venous thromboembolism, but this risk may vary, depending on the underlying cause of immobility. METHODS:This was a prospective, longitudinal outcome study of self-presenting emergency department (ED) patients who were from 12 hospitals and had suspected venous thromboembolism...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章,多中心研究

    doi:10.1016/j.annemergmed.2008.10.033

    authors: Beam DM,Courtney DM,Kabrhel C,Moore CL,Richman PB,Kline JA

    更新日期:2009-08-01 00:00:00

  • Prospective evaluation of mild to moderate pediatric acetaminophen exposures.

    abstract:STUDY OBJECTIVE:To determine whether pediatric patients with acute, mild to moderate acetaminophen exposures, treated with home monitoring alone, develop systemic signs of hepatic injury. METHODS:A prospective, observational study of calls to a regional poison center over a 25-month period was performed. Patients were...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章

    doi:10.1016/s0196-0644(00)70074-6

    authors: Mohler CR,Nordt SP,Williams SR,Manoguerra AS,Clark RF

    更新日期:2000-03-01 00:00:00

  • Development of New Methods to Assess the Outcomes of Emergency Care.

    abstract::This article provides information supporting the need for new outcome measures in emergency care. It also addresses the use of outcome measures in emergency care, the impact of emergency care, identification of at-risk groups, new approaches to measuring patient satisfaction, quality of life and cost-effectiveness, an...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章

    doi:

    authors: Cairns CB,Garrison HG,Hedges JR,Schriger DL,Valenzuela TD

    更新日期:1998-02-01 00:00:00

  • Emergency department documentation in cases of intentional assault.

    abstract:STUDY OBJECTIVE:Emergency department records are an important source of injury surveillance data. However, documentation regarding intentional assault has not been studied and may be suboptimal. The purpose of this study was to analyze physician documentation of assailant, site, and object used in intentional assault. ...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章

    doi:10.1016/s0196-0644(99)70096-x

    authors: Houry D,Feldhaus KM,Nyquist SR,Abbott J,Pons PT

    更新日期:1999-12-01 00:00:00

  • Verapamil in the treatment of PSVT.

    abstract::Verapamil is considered by many investigators to be the drug of choice for the acute management of uncomplicated PSVT. Several clinical investigators have demonstrated termination of PSVT in more than 90% of their patients within minutes following IV drug administration. The incidence of reported severe adverse reacti...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章,评审

    doi:10.1016/s0196-0644(81)80013-3

    authors: Kuhn M

    更新日期:1981-10-01 00:00:00

  • ATLS: a foundation for trauma training.

    abstract::The Advanced Trauma Life Support (ATLS) course is sponsored by the American College of Surgeons Committee on Trauma. This course was developed to provide a consistent method of care for the resuscitation and evaluation of the injured patient. The ATLS course provides an easily remembered method for evaluating and trea...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章

    doi:10.1016/s0196-0644(99)70238-6

    authors: Bell RM,Krantz BE,Weigelt JA

    更新日期:1999-08-01 00:00:00

  • Evaluation of a brief intervention in an inner-city emergency department.

    abstract:STUDY OBJECTIVE:This study tests the effect of a brief intervention with emergency department (ED) patients to reduce at-risk drinking. METHODS:We enrolled patients aged 18 years or older who screened positive for at-risk drinking in an urban academic ED and used alternative allocation to assign them to control or int...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章,随机对照试验

    doi:10.1016/j.annemergmed.2004.10.014

    authors: Bazargan-Hejazi S,Bing E,Bazargan M,Der-Martirosian C,Hardin E,Bernstein J,Bernstein E

    更新日期:2005-07-01 00:00:00