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The researchers created a statistical model to predict the amount of uncompensated care using patient volume and payer type, such as Medicare, Medicaid and indemnity insurance. While hospital ownership public nonprofit, private nonprofit or for-profit leads to very different levels of uncompensated care for hospitals, it did not determine the levels of uncompensated emergency physician care. Emergency physician groups providing the highest levels of free care tended to practice in urban hospitals serving large populations of Medicaid and uninsured patients.

By law, all patients who come through a hospital's emergency room must be examined regardless of their ability or willingness to pay or whether the medical complaint is an emergency. The number of uninsured patients in Florida and nationwide is growing even as discounts negotiated by private insurance plans and government programs such as Medicaid and Medicare continue to squeeze reimbursement for health services. Thus, the researchers suggest, an emergency physician group's ability to shift costs from uninsured to insured patients to offset declining revenue is increasingly limited. Furthermore, unlike hospitals, emergency physician groups do not offer other non-emergency services that could help subsidize unfunded emergency care.

"We have a government mandate to take care of all Florida residents and visitors who come through our doors, without provisions to help pay for it," said Dr. Lopez, president of Florida Emergency Physicians, an independent group of emergency physicians covering seven hospitals in Central Florida. "We are among the first responders entrusted to provide vital services in times of medical crises, yet we do not enjoy the same sovereign immunity protection as paramedics, police and firefighters."

FCEP and its parent organization, the American College of Emergency Physicians, advocate for fair reimbursement to defray the cost of emergency care and m
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Contact: Anne DeLotto Baier
abaier@hsc.usf.edu
813-974-3300
University of South Florida Health
22-Dec-2005