The study, led by researchers at Ann Arbor-based University of Michigan, found 19.2 percent of emergency room patients treated and released in 2019 exhibited high-intensity billing, up from 4.8 percent in 2006.
The authors found 47 percent of this increase was expected based on shifts in administrative measures and more care services available in claims data.
The authors also posit emergency rooms are seeing sicker, more complex patients, leading to an increase in high-intensity billing, defined as billing coded as high complexity or critical care.
“In addressing potentially inappropriate billing practices, payers must acknowledge the increasing complexity of care for a treat-and-release ED patient population composed of older, more comorbid, and clinically undifferentiated patients, to avoid hospitalization, ensure safe discharge, and improve acute care outcomes,” the authors concluded.
Read the full study here.
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