Managed care and emergency medicine: conflicts, federal law, and California legislation.
The traditional use of the American ED, one of unrestricted access by patients and payment for services by insurers, is being questioned in this era of health care reform. Both primary care physicians and managed care organizations have questioned the use of the ED by patients without obvious problems of an emergency nature. We attempt to address this issue from the emergency medicine and managed care perspectives.
Derlet
R W
RW
Emergency Department, University of California, Davis, Sacramento, USA.
Young
G P
GP
D002140:California; D003361:Cost Allocation; D004630:Emergencies; D004636:Emergency Service, Hospital / Q000191:economics* / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data; D006279:Health Maintenance Organizations / Q000458:organization & administration; D006801:Humans; D007883:Legislation, Medical; D008329:Managed Care Programs / Q000191:economics / Q000331:legislation & jurisprudence* / Q000458:organization & administration; D010360:Patient Transfer / Q000331:legislation & jurisprudence; D012051:Reimbursement Mechanisms; D014481:United States