The Institute of Medicine released three new reports that find the nation's emergency care system is fragmented, stretched to the breaking point, and severely compromised in its ability to handle disasters. The reports call for Congress to establish a pool of at least $50 million to reimburse hospitals for uncompensated emergency and trauma care. According to the reports, lawmakers should significantly increase funding to provide hospitals with resources needed to handle disaster situations. The reports also say that Congress should allocate $88 million to be disbursed as grants over five years for projects that can test ways to promote greater coordination and regionalization of emergency care, and that it should appropriate $37.5 million each year for the next five years to the Emergency Medical Services for Children Program, to address deficiencies in pediatric emergency care.
Hospitals also need to tackle problems with patient flow and end the practices of diverting ambulances and "boarding" patients until beds become available, the reports say. They recommend that federal programs revise reimbursement policies to reward hospitals that appropriately manage patient flow and to penalize those that fail to do so. The reports also recommend that the Joint Commission on Accreditation of Healthcare Organizations reinstate strong guidelines to reduce crowding, boarding, and diversion, and they call on CMS to convene a working group to develop standards to address these problems.
