The ACEP National Report Card on the

State of Emergency Medicine

VACEP Talking Points

Introduction

• Thanks to ACEP.         The Virginia College of Emergency Physicians would like to thank the American College of Emergency Physicians for undertaking this difficult project.  It reflects an extraordinary effort on the part of ACEP and, if used correctly, will establish a useful reference point in the discourse between emergency care providers, state and national legislators, and public health and policy makers.

• Report is a tool.           This report is a tool that can be used by leaders in medicine, government, and public health to address and improve an issue of great importance to all Americans:  the ability to deliver quality emergency care to every individual in a timely and effective manner.

• Examine report globally.         As is true when any set of data is compiled, there may be important variables that were not included or individual data points that are incorrect or incomplete.  It is important, as this tool is used, to look past the overall grade and focus on how each data element can be used to improve the environment of care in the Commonwealth.  By doing this, government officials and health care providers can collaborate in a way that will maximize the use of currently available resources and develop means by which new resources can be generated.

Why This Report Is Important

• Emergency services essential.            Emergency care is an essential public service and it must remain viable and efficient.  Through identifying strengths and weaknesses,  this report allows public health resources to be utilized in way that maximizes individual patient benefit and minimizes the adverse effect of stressors on the healthcare system overall.

• Common data set.        This report allows federal, state, and local governmental agencies, public health officials, and emergency health care providers to examine and interpret a common data set, eventually leading to discussions of how these and other important additional variables can be measured and understood.

Virginia’s Areas of Excellence

1. Advanced 911 services.           Virginia has a system which ranks it 11th for the number of people with access to advanced 911 services, getting life saving services to patients faster.

1. Strong Emergency Medicine residencies.      Virginia is fortunate to have a strong group of Emergency Medicine residency training programs.  This allows for future generations of emergency physicians to be able to train and practice in our state.

1. Public Health & Injury Prevention.  This area produced overall good marks for Virginia by scoring well in alcohol-related fatalities, traffic fatalities, and occupational injuries.  While the score was overall positive, there are still several steps that can be mounted to improve this score.

Virginia’s Potential Areas for Improvement

1. Expanded hospital Emergency Department’s and hospital staffed beds to improve the access to the system.             Because of the low number of the number of emergency departments, the low number of hospital staffed beds, and the overall poor reimbursement, a system of gridlock has occurred.  By hiring and training nurses for throughout the hospital, and expanding the total number of beds in the system, the gridlock can be reduced.

1. Reasonable medical liability reform and support.      Virginia’s governmental officials, health care providers, and legal experts must continue to collaborate in this arena.  This is the only manner in which medical care can be improved in a way that allows for a reasonable use of resources in the support of malpractice coverage.  With the loss of specialists and emergency physicians alike, Virginia’s system is over stretched.

1.  Improve Medicaid reimbursement.               By increasing payment to physicians, Virginia’s General Assembly and Governor could suppress the loss of qualified physicians to surrounding states due to the poor reimbursement in the Commonwealth.  The GA should strongly consider the 10 percent increase for 2006 asked for by VACEP and the Commonwealth Care Coalition.

1. Fix the difficulties with uncompensated care.  By ensuring providers receive payments directly from insurance companies, the cost of undercompensated care will be reduced.  This will allow physician groups to remain competitive with surrounding states.

Conclusions

• ACEP report provides an opportunity.           This report provides a strong starting point into the discussions that must occur.  The lawmakers, citizens, and healthcare providers must keep the access to emergency medical care in the forefront.

• Common goal:  improve emergency services.            While there surely will not be agreement on the data variables selected, the veracity of the data, or the implications of the data in improving care, it should be acknowledged that we are all in complete agreement that we wish to wisely use our talents and the available healthcare resources to improve the emergency care of patients in Virginia and the nation.