ACEP Takes Issue with Statements Made Today by Insurance Giant Health Net, Inc. Regarding Emergency Visits

Sep 08, 2011, 18:02 ET from American College of Emergency Physicians (ACEP)

WASHINGTON, Sept. 8, 2011 /PRNewswire-USNewswire/ -- Aiming to stop the spread of inaccurate information regarding America's emergency care system, Dr. Sandra Schneider, president of the American College of Emergency Physicians (ACEP), today issued the following statement:

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"The nation's emergency physicians take issue with the efforts of health insurance companies to prevent emergency visits.  It may save some money for them, but it's bad for patient health and potentially life threatening.  It also violates the spirit of the prudent lawperson law, which requires insurance plans to pay for emergency care based on whether an average person would believe they have the symptoms of a medical emergency.

"In addition, emergency care represents less than 2 percent of the nation's health care dollar, so preventing emergency visits will never put a significant dent in the nation's soaring health care costs.

"The fact is; most emergency patients appropriately seek emergency care.  Less than 8 percent of emergency visits are classified as nonurgent by the National Center for Health Statistics, which also says 'nonurgent' does not mean unnecessary.  Nonurgent visits can include broken bones and kidney infections that require treatment within two to 24 hours.  

"These health plan tactics are dangerous because it puts people in situations of having to self-diagnose their medical conditions — out of fear the plans won't pay, for example, when their chest pain turns out to be heart burn.  Health plans send messages to their beneficiaries not to make any 'unnecessary' emergency visits.  But it's not that simple — I've seen people with mild symptoms turn out to have life-threatening emergencies.  Many people also wait too long to seek medical care, which can be life-threatening with headaches that turn out to be strokes or stomach aches that turn out to be aortic aneurisms.

"This is a very simple message we want to share with all Americans — if you think you're having a medical emergency, go to an ER immediately.  Leave the diagnosis to the experts:  emergency physicians."

In addition, Dr. Schneider pointed out that ACEP never advises people when NOT to go to the emergency room.

ACEP educates people about when to seek emergency care.  

ACEP is a national medical specialty society representing emergency medicine. ACEP is committed to advancing emergency care through continuing education, research and public education. Headquartered in Dallas, Texas, ACEP has 53 chapters representing each state, as well as Puerto Rico and the District of Columbia. A Government Services Chapter represents emergency physicians employed by military branches and other government agencies.

SOURCE American College of Emergency Physicians (ACEP)



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