title: The financing of hospital-based emergency departments.
abstract: This article describes the principal channels of reimbursement for hospital-based emergency departments, and considers the impact of these funding streams on the organization and delivery of emergency care. We describe the services offered in the emergency department setting, reimbursement methodologies, factors affecting reimbursement, and the costs of hospital-based emergency services. We examine hospital financing and the contribution of the emergency department to the hospital's patient and service mixes and to its financial bottom line. We identify perverse payment incentives in terms of quality, efficiency, and broad system goals, and consider how payment incentives can be used to improve patient safety and quality of care.
authors.affiliation: Center for Policy & Research in Emergency Medicine, Oregon Health & Science University, Portland, OR, USA.
authors.forename: K John
authors.initials: KJ
authors.lastname: McConnell
authors.forename: David
authors.initials: D
authors.lastname: Gray
authors.forename: Richard C
authors.initials: RC
authors.lastname: Lindrooth
mesh_terms: D039702:Current Procedural Terminology; D004469:Economics, Hospital; D004636:Emergency Service, Hospital / Q000191:economics* / Q000458:organization & administration; D005249:Fees and Charges; D005377:Financial Management, Hospital; D007357:Insurance, Physician Services; D012051:Reimbursement Mechanisms; D017664:Uncompensated Care; D014481:United States