Emergency departments in the United States handle 120 million to 140 million visits each year. They are where patients seek care for time-sensitive and acute conditions, and they provide that care regardless of an individual’s ability to pay, serving as the safety net of the nation’s health system.
But according to a new RAND study, the viability of emergency care as we know it is at risk. That’s because emergency departments face serious challenges, including long patient wait times, increasing patient complexity and acuity, and a high amount of uncompensated care.
Declining payments may be particularly concerning. Medicare and Medicaid payments to emergency physicians fell 3.8 percent from 2018 to 2022. Over that same period, reductions in payments for commercially insured patient visits were much steeper, dropping 10.9 percent for commercial in-network visits and 47.7 percent for commercial out-of-network visits.
Urgent action is needed to sustain hospital emergency departments, says lead author Mahshid Abir, a RAND researcher and a practicing emergency physician. “Unless these challenges are addressed,” she says, “there is an increasing risk that emergency departments will close, more doctors and nurses will leave emergency medicine, and patients will face even longer waits for care.”
