ACEP: Access to Emergency Care in U.S. Declining

The American College of Emergency Physicians released its latest report card on America’s support for emergency care on Tuesday, dropping the nation’s overall grade since 2009’s C- to a 2014 grade of D+.

“This report card is sounding an alarm,” says ACEP President Alex Rosenau. “As the role of emergency care is expanding, the nation’s policies are failing to support emergency patients.”

The reasons for the drop include hospital closures and a dwindling number of psychiatric beds. ACEP predicts that emergency care will continue to be stretched further as additional people acquire health insurance and seek medical care, but find that primary care physicians have no room for new patients or won't take them because they can't afford to take on Medicaid patients. "Insurance coverage does not equal timely access to a physician," he says.

The report card also grades individually for all 50 states, the District of Columbia, Puerto Rico and military emergency medicine, and forecasts how the role of emergency medicine will expand under the Affordable Care Act. It has 136 measures in five categories: access to emergency care (30 percent of the grade), quality and patient safety (20 percent), medical liability environment (20 percent), public health and injury prevention (15 percent) and disaster preparedness (15 percent).  The Report Card measures conditions and policies under which emergency care is being delivered, not the quality of care provided by hospitals and emergency providers.

Thirteen states received Fs for disaster preparation, Rosenau notes. Additional red flags included 21 states receiving Fs for access to emergency care and 28 states receiving Ds and Fs for public health and injury prevention.

However, as grim as parts of the report may appear, Rosenau says it doesn't only sound an alarm; it also provides a road map for improvement. In each category, at least one state was able to garner an A and may serve as an example to others. Additionally, the report card website includes recommendations for improving support and a link for contacting your members of Congress.

The top 5 graded states were: D.C., Mass., Maine, Neb. and Colo.

The bottom 5 graded states were: Wyo., Ark., N.M., Mont. and Ky.

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