Even with tougher competition and changes in government and payer policies, the emergency department is still a hospital’s gateway to admissions and a significant source of revenue.
The Emergency Department (ED) used to be a hospital’s gateway, its front door. But EDs are facing new pressures, including the far-reaching requirements and consequences of the Affordable Care Act, competition from other health care providers like urgent care centers and drugstores, and increasingly sophisticated patient demands for specialized care.
In the face of these changes, hospital EDs are morphing into more streamlined systems with wider community outreach and deeper integration of technology.
Here are five trends that are impacting emergency medicine today and helping transform the health care landscape for the near future.
1. Visits to the ED Continue to Increase
According to the Centers for Disease Control and Prevention’s National Center for Health Statistics, in 2014 the number of emergency department visits in the United States was a staggering 141.4 million (45.1 visits per 100 people). Of those, 40 million were injury-related and 11.2 million resulted in hospital admission.
The steady increase in ED visits has been also due to ACA requirements and other government or payer policies, including decreases in primary care reimbursement from Medicaid. According to Becker’s Hospital CFO Report, published in 2015:
EDs are likely looking at increasing volumes, particularly due to shifts (i.e. decreases) in primary care reimbursement from Medicaid. The wildcard here is roughly one year ago many thought Medicaid expansion would depress ED utilization as primary care providers were predicted to absorb a sizeable percentage of the newly insured.
Whatever the reasons for the continuing increase in visits, emergency departments seem to keep providing a sizable portion of hospital revenue, even with a shift to outpatient care.
2. ED Patients Are Aging
EDs are seeing older patients, which aligns with U.S. demographics. ACEP Now reports:
Those persons age 75 and older in 1992 had 558 visits per 1,000 population. In 2011, that number increased to 682 visits per 1,000 population. Similarly, in those persons ages 65 to 74, the utilization increased from 314 to 369. These are the fastest-growing demographics in the country and will continue to grow for the next 20 years.
Because EDs are dealing with predominantly adult patients (as opposed to pediatric) and that population is getting older, EDs must continue to adjust their processes in terms of both structure and functioning to meet changing needs.
3. Increasing Competition Is Driving Improved Patient Outcomes
EDs are facing increasing competition from the proliferation of urgent care centers, employee clinics, and drugstores that offer medical services. As a result, more hospitals are selling their full-service EDs more aggressively with branding and consumer-centered marketing campaigns. Hospitals also are making more of an effort to create a friendly environment and quickly address patient dissatisfaction issues, particularly waiting time. More and more EDs are trying to upgrade and streamline their processes.
4. Demand for Price Transparency Is Growing
Pricing transparency, sometimes called the “retailization of healthcare,” is a growing issue. More EDs are considering implementing consumer-type metrics for transparency in the areas of insurance coverage, collections, and ED charges. This makes perfect sense from the patient’s point of view, especially because the average ED bill has increased dramatically in the past decade. A substantial increase in patients with high-deductible insurance plans has also played a role, putting hospitals on the hook for collecting high self-pay, post-deductible, and co-pay charges.
5. Data Analytics is Getting Deeper
Data technology is increasingly being integrated into the ED environment, from administration to registration to treatment. This not only includes advanced testing and diagnostic systems, but also analytics and business intelligence applications to leverage the hospital’s available data.
Despite the widespread use of electronic health record (EHR) systems, there are still significant limitations of EHR data and its usefulness in assessing performance and making decisions. One reason is an increased workload, which contributes to the slow rate of adoption and burnout. Another reason why EHR systems come up short is the lack of widely accepted metrics, and difficulty integrating with other critical data sources, like billing and coding systems, and patient satisfaction scores.
That’s why more hospital systems are adopting health care data analytics to optimize evidence-based performance, as well as to improve performance across many departments. Data analytics can help improve accuracy in medical diagnosis and decision-making, reduce risk, and increase efficiency, all the while providing a common denominator for measuring results.
Data analytics also can be used to:
- Predict and manage ED workflow
- Develop reliable and actionable data on such factors as population health, cost, and overall ED quality of care
- Obtain and continually monitor metrics on ED-related diagnostics, critical care, mental health, and therapeutics
Even though the modern ED is faced with tougher competition, an aging demographic, and the frequent changes in government and payer policies, it remains the hospital’s gateway to admissions and a significant source of revenue.
That’s why more hospitals are pursuing aggressive acquisition strategies, and implementing advanced data analytics tools to improve patient outcomes and remain competitive. For more information about how d2i’s unparalleled data analytics solutions can benefit your department, please contact us.