The composition, demographics, and disposition of today’s emergency department patients are changing as quickly as the landscape itself, and this is changing how patients pay for EM services. Let’s see if we can connect the dots and get a better sense of the big picture using some of the most current industry information and data.
Patient Experience Is Key
First and most important, in an article in Medscape, Nancy Melville documents the results from two European studies showing that “difficult” patients are frequently misdiagnosed.1 This is obviously most important for its medical-legal implications as well as its impact on patient experience. Wang and colleagues recently reported two significant findings based on the Centers for Medicare & Medicaid Services (CMS) five-star hospital rating system:2
- The number of stars was inversely associated with the risk-adjusted mortality rate.
- Hospitals with higher CMS star ratings were also associated with lower adjusted readmission rates, with five-star hospitals having the lowest readmission rate at 18.7 percent.
The take-home message for emergency physicians is, of course, to first stay totally focused on clinical issues. But it’s also important to be cognizant of the constantly building impact of patient experience-of-care issues and metrics. This is commonly a challenge, with some very sick or injured patients not being particularly open, nor receptive, to your best clinical intentions and actions. Additionally, the entire EM industry continues on its path toward increased commercialization of services: Kutscher reports that in March, HealthEngine offered patients up to $500 for having a preventive colonoscopy.3