EM News: Special Report: Hospitalists, Emergency Physicians, and Cross-Subsidization

AAEM has received more and more calls from emergency medicine groups saying that similar contract negotiations are happening in their institutions, according to Robert McNamara, MD, a professor and the chair of emergency medicine at the Lewis Katz School of Medicine at Temple University in Pennsylvania and the chief medical officer of the AAEM Physician Group, which supports independent physician-owned practices. “We’ve heard a lot from Texas, and it’s also been reported in Virginia and Florida. It’s an issue of economics. The big investor-owned companies are looking for more business, and one of their angles is saying to the hospitals, ‘You give us the lucrative ED contract, and we’ll cover your losses on the hospitalist program.’ That’s very attractive to the C-suite.”

Dr. McNamara said the trend represents a threat to the specialty of emergency medicine. “First, it creates further growth of these large corporate-owned groups, which AAEM believes is not in the best interest of patients,” he said, pointing to reports like the 2012 60 Minutes segment, “Cost of Admission,” in which current and former employees of Health Management Associates said they were pressured to admit patients, whether they needed hospital care or not, to increase revenue. “It’s well documented that corporate influence on medicine and emergency medicine, in particular, can negatively impact patients,” he said.

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Last updated: February 2, 2018

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