Format

Send to

Choose Destination
Health Aff (Millwood). 2018 Dec;37(12):2037-2044. doi: 10.1377/hlthaff.2018.05103.

Use Of Telemedicine For ED Physician Coverage In Critical Access Hospitals Increased After CMS Policy Clarification.

Author information

1
Marcia M. Ward ( marcia-m-ward@uiowa.edu ) is a professor in the Department of Health Management and Policy, University of Iowa, in Iowa City.
2
Kimberly A. S. Merchant is a project manager in the Department of Health Management and Policy, University of Iowa.
3
Knute D. Carter is a clinical assistant professor in the Department of Biostatistics, University of Iowa.
4
Xi Zhu is an associate professor in the Department of Health Management and Policy, University of Iowa.
5
Fred Ullrich is a research specialist in the Department of Health Management and Policy, University of Iowa.
6
Amy Wittrock is a coordinator in the Research Program, Avera eCARE, in Sioux Falls, South Dakota.
7
Amanda Bell is a quality and innovation officer at Avera eCARE.

Abstract

There is a chronic shortage of physicians to cover emergency departments (EDs) in critical access hospitals. A 2013 memorandum from the Centers for Medicare and Medicaid Services clarified that a telemedicine physician could fulfill the regulatory requirements for physician backup when advanced practice providers were at telemedicine-equipped critical access hospital EDs but local physicians were not. In a sample of nineteen hospitals, coverage schedules in 2016 showed that seven had begun the use of tele-ED physician backup for advanced practice providers, decreasing local physician coverage in their EDs. These seven hospitals tended to have decreasing ED staffing costs, while the hospitals not applying this policy showed continually increasing staffing costs over time. Telemedicine also provided other benefits, such as improved physician recruitment and retention. In the future, more critical access hospitals will likely use telemedicine to provide physician backup for advanced practice providers staffing the ED.

PMID:
30633684
DOI:
10.1377/hlthaff.2018.05103

Supplemental Content

Full text links

Icon for Atypon
Loading ...
Support Center