This final project assignment is associated with the NCF (non-completion failure) grade. Failure to complete this assignment will result in the issuance of a grade of NCF if the course average would result in a failing grade in the course. Students should contact their Academic Counselor or Program Director if they have any questions regarding the NCF grade and its implications.
Review the following lecture: See Bottom of page
The Emergency Medical Treatment Active Labor Act (EMTALA)
The project assignment provides a forum for analyzing and evaluating relevant topics of this week on the basis of the course competencies covered.
Robert and Roy, emergency medical technician paramedics (EMT-P), were back on the streets after a slow afternoon of handling administrative tasks in the office. Neither paramedic had checked the divert status board before heading out, so they were unaware that numerous hospitals in the city were on emergency department (ED) divert.
Case Study Eighty-Three: Emergency Divert Status
Read the above case study; your task would be to evaluate this case study utilizing the format below. Make sure to include at least two scholarly/peer-reviewed articles to help support your evaluation.
Case Study Evaluation
Prepare a written report of the case using the following format:
Background Statement: What is going on in this case as it relates to the identified major problem?
What are (only) the key points the reader needs to know in order to understand how you will “solve” the case?
Summarize the scenario in your own words—do not simply regurgitate the case. Briefly describe the organization, setting, situation, who is involved, who decides what, etc. Specifically identify the major problems and secondary issues.
What are the real issues? What are the differences? Can secondary issues become major problems?
Present an analysis of the causes and effects.
Fully explain your reasoning. Declare your role in a sentence or a short paragraph explaining from which role you will address the major problem and whether you are the chief administrator in the case or an outside consultant called in to advise.
Regardless of your choice, you must justify in writing as to why you chose that role. What are the advantages and disadvantages of your selected role? Be specific.
Recognize the strengths and weaknesses of the organization.
Identify the strengths and weaknesses that exist in relation to the major problem. Again, your focus here should be in describing what the organization is capable of doing (and not capable of doing) with respect to addressing the major problem. Thus, the identified strengths and weaknesses should include those at the managerial level of the problem. For example, if you have chosen to address the problem from the departmental perspective and the department is understaffed, that is a weakness worthy of mentioning. Be sure to remember to include any strengths/weaknesses that may be related to diversity issues.
Find out alternatives and recommend a solution.
Describe the two to three alternative solutions you came up with. What feasible strategies would you recommend? What are the pros and cons? State what should be done—why, how, and by whom. Be specific. Evaluate how you would know when you’ve gotten there. There must be measurable goals put in place with the recommendations. Money is easiest to measure; what else can be measured? What evaluation plan would you put in place to assess whether you are reaching your goals?
TIP: Write this section as if you are trying to “sell” your proposed solution to the organization. Convince the reader that your proposed solution is the best available and that it will work as planned. Make sure that the goals you identify are worth the effort required to achieve them!
To support your work, use your course and text readings and also use the South University Online Library. As in all assignments, cite your sources in your work and provide references for the citations in APA format.
The Emergency Medical Treatment and Active Labor Act (EMTALA)
The purpose of the Emergency Medical Treatment and Active Labor Act (EMTALA) is to ensure that any individual who comes to a hospital, through the ER, is cared for, even if he or she does not have insurance. The ability to give this care may be threatened by insufficient capacity, inadequate community resources, and the uninsured and underinsured who have no other resource. Now, some patients, who do not have insurance, have taken to use the ER as their primary care physician (The Ethics Committee, 2005). This is one of the things the Affordable Care Act addressed by expanding the coverage for patients under the Medicaid program.
The Act stops hospitals from financially screening patients, but there is still the practice of “triaging out” patients and treating patients with true emergencies first (Moffat, 2017). So it’s difficult for an ER physician to resolve the conflicting obligations of the patient, the hospital, and the payments that will be incurred by treating someone without insurance, which is commonly filtered into the bad debt budget for the hospital. Those costs can filter out among the rest of the hospital with increased cost to those who do have insurance (The Ethics Committee, 2005).
Another ethical question is how financing medical care should influence individual medical decision making (The Ethics Committee, 2005). This is when the third parties get involved. Many times, a physician will want a specific scan done, e.g., computed tomography (CT) scan and magnetic resonance imaging (MRI). Many times, the insurance company won’t allow it until other steps or scans have been done (The Ethics Committee, 2005) even if the Doctor has documented that the MRI with contrast will show the possible sign of a liver lesion while the CT scan will show only an unclear view. Though many times, the insurance will state that the CT scan should be done, even though it’s inadequate, before they will approve the MRI. It’s a difficult issue for the ER physicians as they are ethically bound to help everyone that comes through the ER doors, but the cost can sometimes be overwhelming for the institution.
Limitations of the EMTALA Law
Review each tab to know more.
EMTALA Law Misinterpretation
Medical Screening Exams
Presents few points of limitations of the EMTALA law along with some examples.
Designed to prevent private hospitals from transferring uninsured or underinsured patients to public hospitals, enforcement and fines seem to come in waves. In 2000, Congress made EMTALA enforcement a priority with nearly as much in penalties in that year as in the previous ten years. EMTALA made national headlines again in 2013 when a Nevada psychiatric hospital was accused of sending patients to California by bus without making arrangements for their care.
Silverman, M. (2015). Keeping up with EMTALA—It’s the law, and it’s good for your patients. Retrieved from http://epmonthly.com/article/it-s-the-law-oh-and-it-s-good-for-your-patients/
Who Pays the Cost for EMTALA?
EMTALA is, indeed, the central factor in the “free-rider” phenomenon. The government forces hospitals to care for these individuals, without financially compensating hospitals for the cost of doing so.
Presents information about how the EMTALA is supported financially and how it benefits or affects the patients(s) or the community. It describes issues in implementation of the law such as how EMTALA may be responsible for raising healthcare costs and other such issues (e.g., how the amount of uncompensated care can increase, how the actual charity care done by hospitals can be reduced due to it, etc.).
Hospitals in areas with a high indigent population must shift more of the cost of unreimbursed care than those in areas of low unreimbursed care. It’s like increasing the taxes in poor areas and lowering taxes in affluent areas. Furthermore, since the bills are different with each patient, some will receive a higher proportion of shift than others. It’s like raising taxes on the sickest patients just because they have the ability to pay.
Plaster, M. L. (2015). Who pays the tab for unfunded care? Retrieved from http://epmonthly.com/article/who-pays-the-tab/
The Ethics Committee. (2005). After the medical screening exam: Non-emergent care and the ethics of access in the emergency department. Retrieved from American College of Emergency Physicians website: https://www.acep.org/life-as-a-physician/ethics–legal/ethics/after-the-medical-screening-exam-non-emergent-care-and-the-ethics-of-access-in-the-emergency-department/#sm.001mlw54q13oeeaaw0w1a9ljewtf9
Moffat, J. C. (2017). Appendix A: The Emergency Medical Treatment and Active Labor Act (EMTALA). In The EMTALA answer book (1–6). Retrieved from EBSCOhost Business Source Complete research database.
From your course textbook, Cases in Health Care Management, review the following cases:
Case 80: No Good Deed Goes Unpunished
Case 81: Saint or Fake?
Case 82: When “Yes” Means “No”
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