Virginia Receives a C- for Not Having Policies to Support Emergency Patients

VACEP President Jake O’Shea was interviewed on local TV and national radio in response to Virginia’s 18th place ranking with a C- in the American College of Emergency Physicians’ (ACEP) state-by-state report card on America’s emergency care environment (“Report Card”). VACEP leaders held multiple meetings to make sure Virginia’s Report Card grade represented the hard work by Virginia’s emergency medicine physicians in as positive way as possible. The state’s best grade was a B- in the category of Quality and Patient Safety Environment, and its worst grade was a near-failing D- in the category of Access to Emergency Care.

Virginia Receives a C- for Not Having Policies to Support Emergency Patients

Virginia’s Access to Emergency Care grade reflects shortages across the entire state health care system. Virginia has a relatively high hospital occupancy rate and below-average per capita rates of emergency departments, staffed inpatient beds and psychiatric care beds. According to the Report Card, investments to bolster hospital capacity and improve Medicaid reimbursement rates, especially to physicians who provide care in emergency departments, would improve this grade.

“Emergency physicians are required by federal law to see every patient who seeks emergency care, yet we are being penalized by the PEND program, which pends, reviews and slashes payments for Medicaid patients.” said Dr. Jeremiah O’Shea, president of the Virginia College of Emergency Physicians.  “Virginia can do several things to shore up support for emergency patients. The first is to end the financially disastrous PEND program that has nearly eliminated Medicaid payments to doctors who treat patients in the ER. The second is to expand access to emergency mental health services.”

The hospital and bed shortages that threaten access to emergency care also weakened Virginia’s Disaster Preparedness grade, which is a C. In addition, the state has a very low rate of intensive care unit beds and only average rates of health professionals registered in the Emergency System for Advance Registration of Volunteer Health Professionals. According to the Report Card, Virginia should implement liability protections for volunteers and health care workers during a disaster to improve this grade.

Virginia’s Quality and Patient Safety Environment grade was the result of ongoing funding of quality improvement efforts within the Emergency Medical Services (EMS) system and funding for a state EMS director. In addition, the state’s destination policies allow EMS providers to take stroke, heart attack and trauma patients directly to appropriate facilities.

Virginia ranked 19th in the country with a C+ in the category of Public Health and Injury Prevention, marking a decline from 2009 when it was ranked 14th with a B. According to the Report Card, despite enactment of legislation to reduce traffic fatalities and improve traffic safety, Virginia needs to pursue efforts, such as implementation of anti-smoking legislation and working to reduce the state’s above-average rates of adult obesity.

Virginia’s grade for Medical Liability Environment, a C, ranked it 25th in the country. The Report Card reported the state has taken positive steps, such as apology inadmissibility laws, to better protect the medical workforce that is federally mandated to treat patients in emergency departments, but there is still room for improvement. Joint and several liability reforms would be a good step.

“America’s Emergency Care Environment:  A State-by-State Report Card – 2014” evaluates conditions under which emergency care is being delivered, not the quality of care provided by hospitals and emergency providers.  It has 136 measures in five categories:  access to emergency care (30 percent of the grade), quality and patient safety (20 percent), medical liability environment (20 percent), public health and injury prevention (15 percent) and disaster preparedness (15 percent). While America earned an overall mediocre grade of C- on the Report Card issued in 2009, this year the country received a near-failing grade of D+.

Click below to listen, and watch, VACEP President Dr. O’Shea address the report.

NPR

Richmond Channel 12 News