Beginning in June 2017, Habersham Medical Center (HMC) will begin prescreening all Emergency Room (ER) patients and will refer patients classified as non-emergent to a more appropriate level of care or charge them an upfront fee to receive ER treatment.
According to Beth Hester, RN and Director of the HMC ER, “Upon arrival, patients will undergo a federally-required medical exam by a qualified medical professional to determine if their symptoms are potentially life-threatening or not. If they do meet the criteria, they will be taken to a room for further treatment.”
“If the initial medical screening determines that their reason for receiving care is not considered a true emergency, they will be given a list of alternative providers or resources in the area or referred from the ER to the ‘most appropriate care facility.’ This may be a local doctor’s office or a walk-in clinic,” adds Hester.
If non-emergent patients wish to be seen in the ER, they will be asked to pay a fee to receive further treatment by an ER provider. This fee will be the insurance co-pay and/or deductible for insured patients or will be an upfront payment for self-pay patients.
While specific details are still being finalized, this type of screening process is becoming more common at hospitals nationwide and will be implemented in part by the $1 million grant Habersham Medical Center received from the Georgia Rural Hospital Stabilization initiative. As one of only three Georgia hospitals to receive this grant for 2017, Habersham Medical Center must use the funds to implement programs to prevent misuse of emergency rooms and reduce costs. If successful, the program will be used as a model for other rural hospitals throughout the state.
“We treat more than 30,000 patients in our ER annually,” says Jerry Wise, HMC CEO. “And a high percentage of these patients are using our ER for primary care and more and more patients are not paying for the care provided. Many insurance companies are also declining to pay or reducing reimbursement amounts for non-emergent ER visits. Consequently, we lost more than $7 million last year from unpaid ER bills. This is a staggering amount, and we have to find a way to best serve our community and stabilize our finances.”
“We have to be available to treat the right patients at the right time and our resources have to be focused on treating those with major illnesses and injuries. Of course, every patient and situation is different, and we may have to make exceptions from time to time,” adds Hester. “And, our staff will also make sure patients understand that they should come back to the ER if they become sicker or their condition worsens; so a new medical screening exam can be provided.”
“A lot of this is really about educating the community on proper usage of the ER and what other community resources are available. The ER is not a walk-in clinic,” concludes Wise. “We have to use our available resources wisely, and we appreciate the public’s understanding as we continue to strive to provide quality care in the most timely and cost efficient manner possible for all patients.”