Financial Viability of Emergency Department Observation Unit Billing Models

Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine
Christopher W BaughMichael A Ross

Abstract

Outpatients receive observation services to determine the need for inpatient admission. These services are usually provided without the use of condition-specific protocols and in an unstructured manner, scattered throughout a hospital in areas typically designated for inpatient care. Emergency department observation units (EDOUs) use protocolized care to offer an efficient alternative with shorter lengths of stay, lower costs, and higher patient satisfaction. EDOU growth is limited by existing policy barriers that prevent a "two-service" model of separate professional billing for both emergency and observation services. The majority of EDOUs use the "one-service" model, where a single composite professional fee is billed for both emergency and observation services. The financial implications of these models are not well understood. We created a Monte Carlo simulation by building a model that reflects current clinical practice in the United States and uses inputs gathered from the most recently available peer-reviewed literature, national survey, and payer data. Using this simulation, we modeled annual staffing costs and payments for professional services under two common models of care in an EDOU. We also modeled cash flows ove...Continue Reading

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Jul 25, 2015·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·Christopher W BaughBenjamin C Sun
Jul 18, 2017·Emergency Medicine Clinics of North America·Jared ConleyChristopher W Baugh

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