Lower reimbursement rates could lead to ER closures

Lower reimbursement rates for doctors who treat uninsured patients in Los Angeles County could ultimately mean the closure of several emergency rooms. The Los Angeles Times reports that prior to a payment freeze implemented by the L.A. County Department of Health Services last July, the reimbursement had been 27 percent of estimated fees for patients under the Physician Services for Indigents Program. Supervisors in the county earlier this week, though, voted unanimously to cut the rate to 18 percent beginning July 1.

With more uninsured coming to the 72 hospitals in the county, (half of which are operating on a deficit, according to the Health Association of Southern California) on-call doctors may decide not to work in the county. If that happens, private hospitals be forced to close emergency rooms, increasing the patient burden on the county hospitals.

"Financing at that level to pay doctors for 24/7 lifesaving emergency care is an insult to the doctors and a further threat to the already-fraying hospital emergency care safety net upon which we all depend," county Supervisor Don Knabe said. "I will move approval only because the alternative is even worse--no payment at all."

The cut was made, in part, due to both the elimination of the $9 million Emergency Medical Services Appropriation--a pool of money the county had expected to use to pay doctors--and a $200 million deficit at the county health department. 

To learn more:
- read the Los Angeles Times article