September 5, 2019

Message from the Chair - Independent FEC Summary

Independent FEC Study (IFECs)

Thanks again for everyone who contributed time and data to the Independent FEC study (IFECs).  The focus of this research project was to describe physician and patient demographics, treatment times, and EMS integration of IFECs.

Our data set included 97,472 patient visits to 18 IFECs in 2018.  Data from these findings were compared to both hospital-based EDs and non-independent FECs from the Emergency Data Benchmark Alliance (EDBA).

Our research found that almost 95% of the IFECs were fully or partially physician-owned, found in 50% suburban, 39% urban and 11% rural areas, and staffed almost completely (95%) by board-certified emergency physicians.  Acuity at presentation was found to be 6% level 1, 13% level 2, 41% level 3, 30% level 4 and 10% level 5.  Insurance coverage was 84% private, 12% self-pay, 2% Tricare, and 1.5% Medicare/Medicaid.  Although no IFECs were being reimbursed for CMS care, 67% would like to be recognized and covered by CMS.

Treatment times for IFECs were quicker than both hospital-based EDs and the EDBA cohort of FECs.  These metrics included length of stay, length of time for discharged patients, admitted patients, door to bed, and door to doctor times.  Regarding EMS integration, 100% of IFECs had ambulance bays, but only 5% received EMS traffic.

This data has been presented at both SAEM in Las Vegas in May and the Internal Conference of Emergency Medicine in South Korea in June.  Dr. Simon, Dr. Schmitz and I are currently working on a submission for publication.

Characterizing Independently Owned Freestanding Departments.jpg

John R. Dayton, MD, FACEP