Managed Care Timeline Luke Medical Center, Pasadena, Essay

Managed Care Timeline

Luke Medical Center, Pasadena, California - established

The change in hospital concentration in 68 large metropolitan statistical areas (MSAs) between 1981 and 1994 is positively correlated with the level of managed care concentration in 1993/1994.

Congress enacted the Emergency Medical Treatment & Labor Act (EMTALA) to ensure public access to emergency services regardless of patients' ability to pay.

4,908 hospitals in the United States have Emergency Departments.

Crowded emergency departments arise because state and federal governments are not providing enough support to public hospitals.

Nearly 18% of hospitals with Emergency Departments (1out of 5) were shut down, according to figures provided by the American Hospital Association.

2001 -- 4,045 hospitals in the United States have Emergency Departments, a drop of 863.

2002 -- Emory Parkway Medical Center, Atlanta, Georgia -- closed. Cause: After 28 years, excluded from participation in some managed care plans.

2002 -- St. Luke Medical Center, Pasedena, California -- closed. Cause: Weak managed care reimbursements.

2003 -- Caledonian Hospital, Brooklyn, New York -- closed. Cause: After 93 years, hospital officials said the facility was underused.

2004 -- 2013 New hospitals opening up are generally specialty hospitals without emergency department. Specializations, such as cardiac, orthopedic, surgical, or behavioral, target specific niche markets and consequently avoid the burdens imposed by the Emergency Medical Treatment and Active Labor Act (EMTALA). Under EMTALA, hospitals with emergency departments must screen any patient presenting at the facility for emergency medical condition (EMC), and if an EMC exists, the patient must be stabilized with treatment. Patients may request transfers to other facilities, or if the hospital is not able to care for the patient under its capability, the patient will be transferred.

2007 - The Robert Wood Johnson Foundation gave grants for a bundled payment project called…