Medicare Admissions from the ED Cost Hospitals Money

Medicare’s reimbursement to hospitals is fixed within any given diagnosis-related group (DRG). These authors compared Medicare dollar margins (patient revenue minus cost) within specific DRGs for patients admitted through the emergency department and for those admitted electively. Using data from the 2003 Nationwide Inpatient Sample of the Healthcare Cost and Utilization Project, the authors calculated dollar margins for more than 1 million admissions to 321 hospitals in 25 states.

Overall, average dollar margins were –US$712 for ED admissions and $22 for elective admissions. For virtually every DRG evaluated, elective admissions were significantly more profitable than ED admissions.