- Such dramatically reduced payments will result in fewer physicians in the ER and much longer wait times, specifically in urban and rural hospitals, which have a higher percentage of Medicaid patients.
- The financial viability of these emergency departments and medical centers is already threatened due to losses from COVID-19 where, during lockdowns, volumes declined as much as 40% due to both a lack of vehicle traffic and patients delaying care and avoiding emergency rooms.
- Underrepresented minorities have always lacked access to healthcare and suffered the worst outcomes in the U.S. This problem was made worse in COVID-19 pandemic. Data from Johns Hopkins University shows that African Americans are three times more likely to contract the novel coronavirus and six times more likely to die from it than any other racial group. Emergency physicians are the healthcare safety net when Medicaid recipients do not have adequate access to primary care and public health. These minority groups would be disproportionately impacted and suffer disproportionately when critical-access hospitals lose Medicaid funding essential to their survival.
- Minorities in the U.S. disproportionately have higher rates of co-morbidities that increase risk factors for COVID-19 (obesity, lung disease, diabetes, hypertension, and other immune-compromising diseases). Many of those conditions are on the “preventable” diagnosis list.
- Finally, some of the listed 800 codes are in fact medical emergencies that can result in significant morbidity or mortality if not treated by appropriate medical staff. I.e. status asthmaticus, diabetic kept acidosis, hypoglycemia, and numerous infections. These disease processes can and do kill patients and downcoding a medical emergency because it wasn't prevented is akin to saying a gun shot wound is not an emergency because the patient could have been somewhere else and avoided getting shot.
Emergency physicians are dedicated to our national mission to promote and strive toward health equity within the communities we serve. Allowing such an unfair policy to go into effect in Virginia would be a significant step backward towards racial equality and social equity.