How healthcare insurance affects medical care in emergency rooms
Health Insurance and the ER
A hospital's emergency room is sometimes a scary place, especially when patients with critical conditions don't have the proper health insurance coverage.
There are a number of questions that arise when uninsured patients arrive at the ER in need of costly medical attention.
In order to help answer those questions, here are just a few ways hospitals handle patients who don't have health insurance coverage:
No One is Turned Away
For uninsured patients in need of medical attention that requires an emergency room visit, ERs by law cannot turn away those in need of care.
In 1986, the government passed the Emergency Medical Treatment and Labor Act, which requires all emergency rooms in the United States to treat anyone who walks in.
In other words, if a patient is truly in a life or death medical situation, the ER is the best place to seek treatment, whether the patient is insured or not. Financial repercussions will follow, but money should never come before health and uninsured patients should never avoid the ER due to cost.
Another option for ERs handling uninsured patients is to recommend they apply for charity care. Also known as uncompensated health care, uninsured patients can apply to have their medical bills reduced or completely covered through participating hospitals.
Many hospitals nationwide participate in charity care programs, but the availability of charity care does depend on the patient's situation.
When it comes to how life changes impact health insurance, everything from job loss to divorce can create financial setbacks, but uninsured patients with low incomes can still get the care they need when hospitals participate in charity care programs.
Negotiated Rates and Regular Payments
Hospitals don't like turning patient accounts over to collection agencies in order to receive payment for their services.
Because of this, hospitals suggest that financially unprepared patients negotiate their ER costs with the hospital's billing department before letting their account go delinquent. Most hospitals are willing to reduce patients' medical bills as opposed to turning them over to collections.
Likewise, many hospitals also offer payment plans for those uninsured patients who are unable to cover their medical costs upfront.
Depending on the costs involved, hospitals are more than willing to work with patients by setting up monthly payment plans as long as patients make regular payments until the balance is paid off.
Urgent Care Clinics
In some cases, patients rush to the ER under the impression they need immediate attention when they actually don't.
If the emergency room staff and technicians decide a patient isn't in need of immediate medical attention, they can redirect them to the nearest walk-in clinic.
Although the ER can't turn away the patient, they can suggest that the patient seek attention at a walk-in clinic to avoid the high hospital fees, which is extremely beneficial advice for the uninsured.
Walk-in clinics and urgent care clinics can handle a wide range of medical issues like lacerations that require stitches, sprains and strains, minor allergic reactions, and minor burns.
But if the patient is experiencing signs of a heart attack, stroke, severe shortness of breath, poisoning, gunshot or stab wounds, or head trauma, the ER is definitely necessary.
When it comes to health insurance and the ER, there are plenty of options for the uninsured when visiting the emergency room.
About the Author
Adam Groff is a freelance writer and creator of content. He writes on a variety of topics including social media and personal health.
Women leading in healthcare means better patient outcomes
I know I’m pointing out the obvious, but women are different to men. In the context of healthcare—a woman’s physiology, symptoms and sometimes even treatment options are different from a man's. We have witnessed this in cardiovascular health, where there is ample research and evidence that women’s symptoms are often different to men’s. We also know that heart disease is responsible for 1 in 3 deaths in women annually—it is the number one killer.
The fact is women do not always get the treatment they need. A lot of that has to do with who is treating them, how they are being treated by their physicians and the healthcare systems that are designed to support patient needs.
The proof is in the research at the care level; a 2017 study of hospitalised patients over the age of 65, examined differences in outcomes based on the gender of the treating physician. The results of the study concluded that patients treated by female physicians had lower mortality and readmission rates compared with those cared for by male physicians.
Gender equity starts at the top
I believe that gender equity in healthcare starts at the top with the leaders who set expectations around workplace culture, and that trickles down to the workforce.
You might think gender has nothing to do with how patients are treated—a patient is a patient, regardless of age, ethnicity, religion, creed, color or gender. But I believe there is a correlation between female leadership in healthcare and better patient outcomes—for men and women. Despite a predominantly female workforce in healthcare (65% of healthcare workers are women), only 13% of healthcare CEOs are women.
The disparity in the number of women in the healthcare C-suite is irrefutable, but I believe the more diversity we have at the boardroom table in hospitals and health systems— and that includes women—the more perspectives we bring to the decisions that ultimately impact patients and their families.
Female healthcare leaders are also caregivers
Many women are still the primary caregivers at home. The responsibility of grocery shopping and meal planning, making doctor and dentist appointments for children and elderly parents, and everything in between still tends to fall to women.
This lived experience gives women the ability to think about innovations and solutions from the perspective of the caregiver—not just the patient. The fact is when someone is sick in the family, it affects the whole family.
As a woman, I often think about solutions and technologies that facilitate holistic healing and health that support the whole family. Bringing the mentality of inclusion to healthcare leadership means programs like the American Heart Association’s Go Red for Women campaign, will ensure research and treatment for cardiovascular disease in women will get the attention it deserves and ultimately, better outcomes for patients.
The bottom line and meaningful work are equally important
A 2019 study found that public companies with a female CEO were more profitable than their competitors with men at the helm, but that didn’t come at the cost of job fulfillment.
Women who lead companies and organisations can influence their workforce by rallying around a common cause. Having meaningful work and the opportunity to make a difference in the world is powerful motivation that doesn’t have to come at the cost of profitability.
The work we do at Abbott is a good example—I consistently reinforce the good that comes from the research and development of the products we make with my team. Clinical trials, like the current LIFE-BTK trial, is consciously recruiting female principal investigators who work with underserved populations to enroll patients from communities of color and women. Knowing the work we do has a social impact on society might be difficult to quantify, but in my opinion, it’s priceless and could lead to meaningful treatment options that improve patient outcomes in the long-term.
Emotional intelligence and empathy are not soft skills
Interpersonal skills, problem-solving and self-awareness are considered “soft skills”—skills that might not be required to do the job, but in leadership positions, they are no longer “nice to haves,” they are “need to haves” if you are going to inspire high-performing teams.
Research suggests women tend to score higher on social and emotional competencies than men. In the words of Joanne Conroy, the CEO and President of Dartmouth-Hitchcock Health in New Hampshire, “Diverse representation at the table changes the conversation. It becomes more collaborative; there is more listening and less interrupting. We have better conversations about how we are functioning as a team and we create a safe space when people can be honest with their feedback to all members of the team, including the leader.”
I’m not suggesting women have a monopoly on soft skills, however having gender diversity around the boardroom table means a diversity of skills. Being aware of your team’s morale and what motivates them is equally important as managing your supply chain.
When it comes to health, we know that patients want more personalised care. The emergence of artificial intelligence (AI) has the potential to generate data that is tailored to the health needs of women and ultimately lead to better treatment options and outcomes. But the data insights generated by AI are only as good as the patients’ data available for analysis. To maximize the potential of AI—and meet the expectation of personalised care for patients—healthcare leaders need to be aware of who is and isn’t being included in studies and clinical trials, like women, and telegraph the need for greater inclusion to their teams.
These ideas are just the tip of the iceberg. Sure, we have come a long way since Elizabeth Blackwell—the first female physician in the United States—founded New York Presbyterian Hospital. Sure, there is still plenty of work to do, but I do hope my contribution is paving the way for more women to take on leadership roles in healthcare and make a positive impact on lives of all patients and their families.