Free care by Florida emergency physicians climbs faster as uninsured patient visits increase

Hospital emergency physician groups serving an increased volume of uninsured patients had disproportionately higher rates of free, or uncompensated, care a consequence that may worsen overcrowding, adversely impact quality of care and lead more emergency rooms to close their doors, University of South Florida researchers found. USF worked with the Florida College of Emergency Physicians (FCEP) on the study, which is published in the October-December 2005 issue of Health Care Management Review.

The researchers surveyed 188 Florida hospital emergency physician groups about the uncompensated care they provided in 1998. The 83 physician groups responding provided substantial uncompensated, or free, emergency care, ranging from 26 to 79 percent with an average of nearly 47 percent.

Uncompensated services are those for which no payment is received from either the patient or from a public or private insurer. Such services encompass charity care for patients who cannot afford to pay, bad debt from patients who choose not to pay their portion of the bill, and denial of payment for emergency services by health plans.

"This study is one of the first to quantify the uncompensated care provided by Florida emergency physicians," said lead study author Barbara Langland Orban, PhD, associate professor and chair of Health Policy and Management at the USF College of Public Health. "Emergency physicians say the large amount of uncompensated care they provide has become a substantial cost of practicing emergency medicine, but we did not expect such a high percentage of free care."

"Legislators and the public need to recognize that uncompensated care is not just a problem involving uninsured patients it affects all patients," said FCEP President Jorge Lopez, MD. "The same standard of care is provided to everyone who comes through the emergency department. If that care deteriorates from lack of adequate funding and resources, it deteriorates for ever

Contact: Anne DeLotto Baier
University of South Florida Health

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