Report Points to Growing Specialist Staffing Issue in California Hospitals
California hospital leaders say it is becoming increasingly difficult to find the required type of physician specialists to be on call in emergency departments, according to a new survey, HealthLeaders Media reports.
For the survey, researchers polled 110 hospital CEOs and ED managers. The survey was conducted by the Performance Alliance and USC's Center for Health Financing, Policy and Management and was released by the California HealthCare Foundation, which publishes California Healthline.
According to the report, more attention is being paid to how EDs ensure they have the necessary specialists on call, as well as how theyÂ meet legal requirements under the Emergency Medical Treatment and Active Labor Act. The situation is under scrutiny particularlyÂ because the federal health reform law will extend coverage to uninsured individuals.
The report noted that low reimbursement rates for Medi-Cal, California's Medicaid program, can negatively affect the number of specialists who are willing to be on call in EDs.
According to the report, only 60% of EDs reported having specialists available for:
- Cardiac surgery;
- Plastic surgery; or
- Vascular surgery specialists.
The report also found that between 2001 and 2008, on-call expenses for:
- Trauma-designated California hospitals rose by 8% annually; and
- Non-trauma-designated facilities rose by 16% annually.
The specialist-staffing issue is expected to worsen for rural and critical access facilities because specialists are not as likely to live in those areas.
Strategies To Address the Issue
Hospitals are implementing a number of strategies to make they sure they have adequate specialist staff on call in their EDs. For example, facilities are:
- Providing stipends as a form of payment for speciality physicians;
- Contracting with physicians for medical directorships; and
- Allocating a set budget to pay specialists for otherwise uncompensated care (Clark, HealthLeaders Media, 2/14).