How are emergency rooms funded in America?

I have realized a certain trend in the emergency rooms which has been bothering me for a long time now. I came to realize recently that the number of people receiving medical care from emergency rooms without insurance are more than those who are under insurance cover. This made me wonder how emergency rooms are able to sustain their services in America!

How are emergency rooms funded in America? This is a common question that I have come across in various medical platforms and social media pages. People are curious to know how the emergency rooms are funded considering that they sometimes give urgent care to the uninsured who can’t afford the services. In an effort to explain this, I want to take a look at the different types of emergency rooms available in America and how they conduct their business.

There are two main types of emergency rooms in America; freestanding emergency rooms and hospital emergency departments. Freestanding emergency rooms are facilities staffed by emergency services, are open 24 hours a day and are physically separated from the hospital. They may be owned by hospitals or be privately owned by individuals. Freestanding emergency rooms can further be broken down into either hospital outpatient department emergency center or independently owned freestanding emergency room. The main difference between the two subcategories is the fact that the former accepts Medicaid/Medicare payments while the latter does not. The latter are not bound by the federal legislation and regulations regarding operations such as EMTALA. This is not the case in all states though. Some states like Texas for example have passed legislations that impose rules and regulations similar to EMTALA on all the independently owned freestanding emergency departments.

The traditional hospital based emergency rooms on the other hand, operate normally and accept payment from Medicaid and Medicare. They are governed by federal rules and regulations such as EMTALA.

Financial implications for patients visiting the emergency rooms

There is no big difference between the cost of services offered in the freestanding emergency rooms and the hospital based emergency departments. The biggest difference as we have seen comes in when it comes to paying for the services that have been provided. The hospital based emergency rooms will readily treat Medicaid and Medicare as in network while their freestanding independently owned emergency rooms will not accept payment from such forms of payment.

Who funds the emergency rooms?

So, now that we have seen the main differences between the freestanding emergency rooms and hospital-based emergency rooms, it is time to go back to the main issue of who really funds these emergency rooms? How are they able to bridge the gap and financial void left behind when they offer services to the uninsured? This is what it is that normally happens especially in the hospital based emergency rooms;

Hospitals and physicians are normally forced to shoulder the financial burden for the uninsured by incurring billions of dollars in debt each year. This is a very common scenario in America. Actually of all the 140+ million reported emergency room visits, only about 40 million visits were made by insured people and the remaining 55% of the emergency care goes uncompensated. According to the Centers for Medicare & Medicaid Services Health, the accumulative bad debt or amount of money accrued by uninsured people receiving urgent medical care is in the neighborhood of $200 billion every single year. A study recently conducted by the American Medical Association showed that more than one-third of emergency physicians lose an average of $140,300 each year from EMTALA-related bad debt. So, how are emergency rooms still able to make profit with such figures? How do they make up for the lost funds?

In an effort to offset the bad debt, hospitals in the recent past shifted uncompensated care costs to insured patients to make up the difference. This basically meant that the insured patients were forced to help carry the burden of uninsured patients. This is however not applicable today. Owing to numerous complaints and lawsuits by insurance companies and individuals, cost shifting was done away with. It therefore is no longer is a viable option because managed care and other health plans have instituted strict price controls to their insurance plans. This means that there is very little leeway and margin for the emergency rooms to try and squeeze in some of the bad debt through cist shifting.

Things are not looking any good though. With projections that health care costs will double in the coming few years and the number of uninsured Americans not showing signs of reducing, emergency rooms and other medical service providers will have to keep bearing with the burden. The nation will have to keep providing for not just the disadvantaged in the society but for the uninsured as well.


Nanoparticles Used in Medicine Today

People are living longer and healthier lives with every passing year as medical technology continues to progress in previously unthinkable ways.  For instance, imagine a tiny supercomputer that can enter your body and diagnose any health problems from the inside out.

Believe it or not, this isn’t science fiction; this nanotechnology is already under development to make this a reality through the use of nanoparticles.

What are Nanoparticles?

By definition, a nanoparticle is a very small object or chemical that, in terms of its transport and properties, behaves as a whole unit and ranges in size from 1 to 100 nanometers.  To give you an idea of how small that is, try to picture the width of an 8,000th of a hair.

Although they’re being manufactured for medical purposes now, nanoparticles weren’t invented by humans; these microscopic flecks are naturally occurring in things like milk, volcanic ash, and clay.

How are nanoparticles being used?

Many applications for nanoparticles are still in the preliminary testing phase.  Drug delivery and early cancer detection are some of the most competitive utilizations.  In fact, Google recently joined the nanomedicine race.  Their technology is a long term diagnostic particle that binds to disease-causing cells.  The patient would wear a magnetic bracelet that alerts them when dangerous molecules are detected, however, this plan is still in its infantile stages.

Currently, there are some nanotechnology-based drugs that are FDA approved for commercial use or are in their final human testing trials:

  • Cornell dots (Clinical trials) – Used by surgeons to determine the exact location of tumors with the help of a florescent dye.
  • Doxil (FDA approved) – Used to treat ovarian cancer and multiple myeloma (a type of bone marrow cancer).  The drug is encased in lipid layers that target the cancer while reducing damage to the heart, which is a side effect of the treatments.
  • Abraxane (FDA approved) – Used to treat breast cancer, pancreatic cancer, and lung cancer.

Nanomedicine is a fairly new way to treat disease, but scientists believe that the possibilities are endless.  Only time will tell just how much this technology will accomplish and improve the quality of life for mankind.

Las Nanopartículas Utilizadas en la Medicina de Hoy

La gente vive vidas más largas y más saludables con cada año que pasa como la tecnología médica continúa progresando de manera antes impensables. Por ejemplo, imagine una pequeña supercomputadora que puede entrar a su cuerpo y diagnosticar cualquier problema de salud desde adentro hacia afuera.

Lo creas o no, esto no es ciencia ficción; este nanotecnología ya está en fase de desarrollo para hacer de esto una realidad a través de la utilización de nanopartículas.

¿Cuáles son las Nanopartículas?

Por definición, una nanopartícula es un objeto muy pequeño o químico que, en términos de su transporte y propiedades, se comporta como una unidad completa y oscila en tamaño desde 1 a 100 nanómetros. Para que te hagas una idea de lo pequeño que es, tratar de imaginar el ancho de un 8000o de un cabello.

A pesar de que están siendo fabricados con fines médicos ahora, las nanopartículas no fueron inventadas por los seres humanos; estas motas microscópicas son de origen natural en cosas como la leche, la ceniza volcánica y arcilla.
¿Cómo se están usando nanopartículas?

Muchas aplicaciones de las nanopartículas se encuentran todavía en la fase de pruebas preliminares. La entrega de medicamentos y la detección temprana del cáncer son algunos de los usos más competitivos. De hecho, Google se ha unido recientemente la carrera de la nanomedicina. Su tecnología es una partícula de diagnóstico a largo plazo que se une a las células causantes de enfermedades. El paciente podría llevar una pulsera magnética que les avisa cuando se detectan moléculas peligrosas, sin embargo, este plan se encuentra todavía en sus etapas infantiles.

Actualmente, hay algunos fármacos basados en la nanotecnología que son aprobados por la FDA para su uso comercial o están en sus ensayos finales de prueba humanos:

  • puntos de Cornell (ensayos clínicos) – utilizado por los cirujanos para determinar la ubicación exacta de los tumores con la ayuda de un colorante fluorescente.
  • Doxil (aprobado por la FDA) – Se usa para tratar el cáncer de ovario y el mieloma múltiple (un tipo de cáncer de médula ósea). El fármaco está encerrado en capas de lípidos que se dirigen al cáncer, mientras que la reducción de daños en el corazón, que es un efecto secundario de los tratamientos.
  • Abraxane (aprobado por la FDA) – Se usa para tratar el cáncer de mama, cáncer de páncreas y cáncer de pulmón.

La nanomedicina es bastante una nueva manera de tratar la enfermedad, pero los científicos creen que las posibilidades son infinitas. Sólo el tiempo dirá hasta qué punto esta tecnología va a lograr y mejorar la calidad de vida de la humanidad.

Laser Therapy for Joint Pain

New Laser Treatment is Effective and Low Cost

Joint pain is one of the most common medical conditions in the United States – and probably worldwide. It is estimated that more than 50% of Americans live with chronic pain. Probably a majority of these conditions are joint pain conditions. Unfortunately, millions of Americans are spending millions of dollars on prescription drugs in an effort to minimize their joint pain. Most of these powerful prescription drugs only treat the symptoms of joint pain – they don’t treat the cause of the pain.

The good news is that medical technology and techniques continue to advance and now there is a very promising laser treatment that actually treats the cause of joint pain. This is a wonderful and promising treatment that hopefully can be used to treat joint pain as a standard treatment. It is non-invasive and early results demonstrate that it significantly reduces or eliminates pain with a relatively small number of treatments. This is extremely exciting news. Any treatment that addresses the cause of joint pain and allows patients to terminate their use of prescription drugs is a wonderful medical development

What is Laser Therapy for Joint Pain?

The treatment is known as low-level laser therapy or LLLT. One of the pioneers of this treatment method is Dr. Howard Cotler, an orthopedic surgeon based in Houston. He has been quoted in the press multiple times because this is a revolutionary treatment method. It has multiple applications for musculoskeletal pain including the neck, back, and leg and arm joints. Among the benefits are:

1) Reduces Inflammation
2) Reduces Muscle Spasms
3) Reduces Pain
4) Accelerates Repair of Damaged Tissue

In general, one to five laser treatments are common for actue injuries while more difficult chronic injuries may require five to twenty treatments. Each treatment costs between $50 and $100 – a very afforable cost.

Dr. Cotler has pointed out that thisis an FDA approved treatment/device and that it has other applications for promoting the healing of the human body. Some of these applications include the healing of wounds, dentistry. healing of nerve injuries, and ophthalmology.

Since this is a new and revolutionary treatment method most insurance companies will not cover the expenses. But this should change once they realize the effectiveness and low cost of the treatment method.

Click here for more information about this treatment.