Affordable Care Act could strengthen trauma systems

The Affordable Care Act may offer opportunities to improve trauma systems, according to a recent review in Health Affairs.

Trauma systems provide a model of multidisciplinary care consistent with the goals of the Affordable Care Act (ACA). And like current health reform efforts, trauma systems rely on a strong federal-state partnership, supported by guidelines and standards of care developed at the national level that are implemented at the state and local levels, according to the review.

“Recent disasters, both manmade and natural, that injure many people underscore the importance of sustaining a coordinated, regionalized approach to trauma and emergency care that is adequately funded and ready to respond in any region of the country,” A. Brent Eastman, MD, FACS, immediate past president of the American College of Surgeons, stated in a press release.

Section 3503 of the ACA authorizes $100 million in annual grants to help defray substantial uncompensated care costs, further the core mission of trauma centers and provide emergency relief to ensure trauma services remain available. However, the funds have not been appropriated by Congress, according to the reviewers, and full funding of these provisions is needed to stabilize statewide trauma systems that are struggling to survive.

The sustainability and growth of a coordinated regionalized approach to trauma and critical care require a strong federal-state partnership, public funding advocacy and performance-based payment systems that incentivize trauma centers and emergency medical service providers to work together to ensure patients get timely, appropriate treatment, according to the review.

“Treatment of a serious injury in a level 1 or 2 trauma center is expensive,” Ellen J. MacKenzie, PhD, the Fred and Julie Soper professor and chair of the Johns Hopkins Bloomberg School of Public Health’s department of health policy management, stated. “However, such care is cost-effective and overall savings can be realized if patients are treated at a level of care commensurate with the severity of their injuries. Effective communications among emergency medical services, including 911 call centers, dispatch agencies and transport agencies and between EMS providers and hospitals are critical in achieving this goal.”

For more information:

Eastman AB. Health Aff. 10.1377/hlthaff.2013.0716.

Disclosure: Eastman has no relevant financial disclosures.

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