Reform Realtime

Reform Realtime Blog

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With Joanne Barnett, RN, MSN, and Curt Cabral, RN, JD

Nurses are a key part of the acute care team who play a crucial role in redesigning healthcare delivery. This week, Reform Realtime is pleased to welcome Joanne Barnett, Director of Adult Inpatient and Emergency Services at Pomerado Hospital in Poway, Calif., and Curt Cabral, Clinical Director of Emergency Services at Natividad Medical Center in Salinas, Calif., to talk about the changes taking places at their hospitals and the role nurses play in improvement efforts.

8/21/2014 10:51:00 PM | 0 comments

Yesterday, we reported that the number of self-pay patients has been increasing at our emergency departments (EDs) across the country, and we received a lot questions! Namely, if more people are insured, how can that be the case?

Well as it turns out; there are a couple of factors that made it appear that self-pay is rising.

8/8/2014 5:07:35 AM | 0 comments

In this infographic, see what the data from CEP America's 94 EDs across the country tells us about how the payer mix has shifted after many of the new healthcare reform measures took effect. Following the data from previous months, the number of self-pay patients continues to rise while other payer types remain flat.

Does this match what you're seeing at your practice? Leave your observations in the comments section.

8/6/2014 5:17:56 PM | 0 comments

By Joshua Tamayo-Sarver, MD, PhD, FACEP

It's halfway through 2014, and the Reform Realtime data set has matured considerably. This means we're now able to make more meaningful comparisons by controlling for factors like month, year, hospital and geographic location. We're also able to more confidently identify patients covered by state and federal health exchanges.

Being a numbers guy, I'm really excited about this. I've been really curious about the impact of reform on ED volumes (which appear to be rising) and reimbursement (which we all hope will rise).

But as often happens with data, once I started running ours through computer models, I found something unexpected, but equally interesting:

Patients covered through state and federal health exchanges were more likely to present to the ED with high-acuity conditions.

In fact, their overall acuity (on a 5-point scale) was 4.10 versus 3.98 for the non-exchange population. These numbers hold even when controlling for factors like gender and age.

8/5/2014 9:02:54 PM | 0 comments