Th experience in D.C. can be described as a double-edged sword. We are
seeing alot less of the nonurgent patients with colds, rashes, etc. This
makes the ED more interesting and allows us to improve our carefor the
urgent patients. Unfortunately, it has cut into our revenues in a BIG way
becasue kids with otitis and colds used to be big money makers for us.
Instead of a flat fee of $128 that we used to get (whether it be otitis
or a Code Blue), we now get $128 only if it's an ED visit that
RETROSPECTIVELY is reviewed and determined to be appropriate. Otherwise
we get $17.50 as a triage fee. If a nonurgent visit is approved by phone
by the primary care provider (PCP), we get $35.00. OUCH...
111 Michigan Ave, NW
Washington, DC 20010
(202) 884-3253 OFC
(202) 884-3573 FAX
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On Tue, 11 Jul 1995, Jean A. Wright wrote:
> What has been the experience of the pediatric Emergency Medicine community
> when Medicaid moves into a managed care model? Georgia is preparing for
> this in the fall on a voluntary basis, with perhaps an assigned element
> coming later in the year. What can we expect?