Nation Gets a D+ for Its Emergency Care Environment

The American College of Emergency Physicians (ACEP) has a issued a new report, warning that the continuing failure of state and national policies is endangering emergency patients.

ACEP gives the nation a near failing grade of D+ compared to a C- in 2009, when its last report was issued.  America’s Emergency Care Environment: A State-by-State Report Card,” has 136 measures in five categories:

  • Access to Emergency Care (30 percent of the grade): the nation received a D-
  • Quality and Patient Safety (20 percent): the nation received a C
  • Medical Liability Environment (20 percent): the nation received a C-
  • Public Health and Injury Prevention (15 percent): the nation received a C
  • Disaster Preparedness (15 percent): the nation received a C- 

The top ranked states are the District of Columbia (1st, B-), Massachusetts (2nd, B-), 
Maine (3rd, B-), Nebraska (4th, B-) and Colorado (5th , C+).  Ohio scored better than previously, moving from 18th place in 2009 to seventh this year with an overall grade of C+. 

The bottom ranked states include Wyoming (51st, F), Arkansas (50th, D-), New Mexico (49th, D), Montana (48th, D) and Kentucky (47th, D).

 The Report Card contains national recommendations, and ACEP is asking Congress to take the following actions:

  • Fund the Workforce Commission, as called for by the Affordable Care Act (ACA), to investigate shortages of physicians, nurses and other health care professionals.
  • Pass the “Health Care Safety Net Enhancement Act of 2013,” H.R. 36 introduced by Rep. Charlie Dent (R-PA) and the companion legislation S. 961, introduced by Senator Roy Blunt (R-MO). This legislation would provide limited liability protections to (emergency and on-call) physicians who perform the services mandated by the federal EMTALA law, which requires emergency patients be screened, diagnosed and treated, regardless of their insurance status or ability to pay.
  • Fund pilot programs, provided for in the ACA, to design, implement and evaluate innovative models of regionalized, comprehensive and accountable emergency care and trauma systems.
  • Support and fund the mission of the Emergency Care Coordination Center at the Department of Health and Human Services to create an emergency care system that is patient- and community-centered, integrated into the broader health care system, high quality and prepared to respond in times of public health emergencies.
  • Withhold federal funds to states that do not support key safety legislation, such as motorcycle helmet laws and .08 blood alcohol content laws.
  • Fund graduate medical education programs that support emergency care, especially those related to addressing physician shortages in disadvantaged and rural areas.
  • Support efforts to fund emergency care research by the new Office of Emergency Care Research under the National Institutes of Health. 
  • Hold a hearing to examine whether additional strains are occurring in the emergency department safety net as a consequence of the Affordable Care Act.

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