Word: hmos
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Dates: during 2000-2009
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There's a good chance she'll get one. These days, many HMOs as well as Medicare dispute claims on the basis of what constitutes an emergency--rejecting one if, say, a patient who thought he had a heart attack turned out to be suffering from mere heartburn. "We are caught in the middle," says Dr. Stephan Lynn, residency director in the ED at St. Luke's--Roosevelt Hospital in Manhattan, where the medical staff has been cut 15% to 20% over the past five years even as the number of visits has risen 25%. "I get letters from patients...
...moneymaking parts of the hospital. But with the funding cuts in 1997's balanced-budget agreement added to managed care's fiscal pressures, that cushion has all but disappeared. And later this year, new Medicare payment schemes could cause even greater pain for both EDs and ambulance services. "The HMOs and the government have taken the fat out of the system, which used to cover the cost of emergency care," says Dr. Leo Berkenbile, who runs the ED at Verdugo Hills Hospital in Glendale, Calif., the state where EMS is most under siege...