Why patients still need EMTALA
Skip to main content
MDHC_Logotype_white
Subscribe
  • My Account
  • Login
  • Subscribe
  • News
    • This Week's News
    • COVID-19
    • Providers
    • Insurance
    • Government
    • Finance
    • Technology
    • Safety & Quality
    • People
    • Regional News
    • Digital Edition
    • Children's mental healthcare needs skyrocket during pandemic
      Pandemic raises questions about impact of Medicare payment restructuring in post-acute
      Perrigo sells generic drug business for $1.55 billion
      Proposed overhaul of Arkansas Medicaid expansion unveiled
    • Children's mental healthcare needs skyrocket during pandemic
      Pandemic raises questions about impact of Medicare payment restructuring in post-acute
      Tensions over vaccine equity pit rural against urban America
      States easing virus restrictions despite experts' warnings
    • The Check Up: Dr. Marc Boom
      The Check Up: Dr. Marc Boom of Houston Methodist
      Dr. Marc Boom
      Q&A: Houston Methodist CEO praises staff efforts to keep vaccine efforts going during ice storm
      Charles-Shor_160x200 1_i.jpg
      Cleveland Clinic receives $15.5 million donation for new neurological institute
      The Check Up: Dr. Imran Andrabi
      The Check Up: Dr. Imran Andrabi of ThedaCare
    • Highmark, HealthNow finalize affiliation, creating fourth-largest Blues plan
      Low 2020 utilization could affect insurer profits for the next two years, analysts say
      CMS: Group health plans must cover COVID-19 diagnostic testing
      High MLRs inspire insurers to focus on quality improvements
    • Pandemic raises questions about impact of Medicare payment restructuring in post-acute
      Proposed overhaul of Arkansas Medicaid expansion unveiled
      States easing virus restrictions despite experts' warnings
    • UPMC's patient volumes stabilize, boosting 2020 profits
      Genomics firms taking advantage of SPACs trend to go public faster
      COVID-19 could dent hospital revenue by at least $53 billion in 2021, AHA says
      deloitte GDP image chart graph going up
      Sponsored Content Provided By Deloitte
      Breaking the cost curve
    • Teladoc reports $383.3M in fourth-quarter revenue, up 145%
      man and woman looking at ipad wearing face masks stock image
      Sponsored Content Provided By Surescripts
      Improvements to benefits data can enhance ePrescribing and the patient experience
      Oscar Health's $1B IPO sets the stage for more health tech exits in 2021
      A map of the U.S. with images of the coronavirus.
      The digital divide becomes a new social determinant of health
    • Children's mental healthcare needs skyrocket during pandemic
      Tensions over vaccine equity pit rural against urban America
      Utah cancels vaccine appointments after registration error
      Connecticut is doling out vaccines based strictly on age. It's simpler, but is it fair?
    • Alicia Wilson
      Q&A: Emerging leader Alicia Wilson on staying close to home
      Michael Jordan, Novant team up to address health equity
      Former Ascension CEO, the first to lead the health system, passes away
      Biden's pick to head CMS would be first Black woman to hold post
    • Midwest
    • Northeast
    • South
    • West
  • Insights
    • ACA 10 Years After
    • Best Practices
    • Special Reports
    • Innovations
    • The Affordable Care Act after 10 years
    • Dr. John Fischer
      Patient-reported outcomes tool for hernia surgery helps physicians improve care
      New care model helps primary-care practices treat obesity
      doctor with patient
      COVID-19 treatment protocol developed in the field helps patients recover
      Rachel Wyatt
      Project to curb pressure injuries in hospitals shows promise
    • What's next for on-demand telehealth companies?
      A CalOptima PACE vaccination clinic.
      Will COVID-19 be the catalyst for creating a more sustainable healthcare system?
      A map of the U.S. with images of the coronavirus.
      The digital divide becomes a new social determinant of health
      Ascension’s St. Mary’s Hospital Surgery Center at Towne Centre and Allegheny Health Network’s Bethel Park surgery center
      Hospitals see opportunity, risk in ambulatory surgery centers
    • Dr. Daniel Hall
      UPMC pilots machine learning, telehealth to inform patient transfers
      A woman being recorded using her inhaler on a smartphone.
      Digital check-ins, connected inhalers help control asthma
      A phone screen showing the question, "Mary we hope this information was helpful and we'd like to keep guiding you. Are you interested in knowing when it's your turn to receive the vaccine?"
      Chatbots, texting campaigns help manage influx of COVID vax questions
      A woman with a wearable sensor talking to her provider.
      Wearable sensors help diagnose heart rhythm problems in West Virginia
  • Transformation
    • Patients
    • Operations
    • Care Delivery
    • Payment
    • What's next for on-demand telehealth companies?
      Rising prescription copays drop adherence, spike mortality, research shows
      Dr. John Fischer
      Patient-reported outcomes tool for hernia surgery helps physicians improve care
      Highmark Health inks six-year cloud, tech deal with Google
    • Hospitals' Medicare billing practices suggest upcoding, OIG says
      California hospitals prepare ethical protocol to prioritize lifesaving care
      Amazon, JPMorgan Chase, Berkshire Hathaway disband Haven
      Digital pathways poised to reshape healthcare continuum in 2021
    • Dr. Daniel Hall
      UPMC pilots machine learning, telehealth to inform patient transfers
      A woman being recorded using her inhaler on a smartphone.
      Digital check-ins, connected inhalers help control asthma
      Humana partners with in-home provider for 24/7 care
      A phone screen showing the question, "Mary we hope this information was helpful and we'd like to keep guiding you. Are you interested in knowing when it's your turn to receive the vaccine?"
      Chatbots, texting campaigns help manage influx of COVID vax questions
    • Bundled payments reduce surgery costs by 10.7%
      Coordinated payment policies could speed transition to value, experts say
      CMMI's geographic direct contracting model needs an overhaul, experts say
      Hospitals fight UnitedHealthcare policies over lab test, specialty drug payments
  • Data/Lists
    • Rankings/Lists
    • Interactive Databases
    • Data Points
    • Health Systems Financials
      Executive Compensation
      Physician Compensation
  • Op-Ed
    • Bold Moves
    • Breaking Bias
    • Commentaries
    • Letters
    • Vital Signs Blog
    • From the Editor
    • Dr. Alan Kaplan
      The risks, rewards of taking organizations 'where they haven’t gone before'
      Wellstar CEO calls adapting for the pandemic her bold move
      Howard P. Kern
      Recognizing the value of telehealth in its infancy
      Dr. Stephen Markovich
      A bold move helped take him from family doctor to OhioHealth CEO
    • Dr. Stephen Markovich
      Making sure we're aligned along the path to achieving inclusion
      Barry Ostrowsky
      Ending racism is a journey taken together; the starting point must be now
      Laura Lee Hall and Gary Puckrein
      Increased flu vaccination has never been more important for communities of color
      John Daniels Jr.
      Health equity: Making the journey from buzzword to reality
    • Mikelle Moore
      The promising future of rural healthcare, even amid the COVID-19 pandemic
      In-person visitation must be part of the national COVID-19 response
      We've lost so much to the pandemic, but we've also made gains that will endure
      Medical groups key to meeting president's vaccine pledge
    • Letters: Eliminating bias in healthcare needs to be ‘deliberate and organic’
      Letters: Maybe dropping out of ACOs is a good thing for patients
      Letters: White House and Congress share blame for lack of national COVID strategy
      Letters: VA making strides to improve state veterans home inspections
    • Sponsored Content Provided By Optum
      How blockchain could ease frustration with the payment process
      Sponsored Content Provided By Optum
      Three steps to better data-sharing for payer and provider CIOs
      Sponsored Content Provided By Optum
      Reduce total cost of care: 6 reasons why providers and payers should tackle the challenge together
      Sponsored Content Provided By Optum
      Why CIOs went from back-office operators to mission-critical innovators
  • Awards
    • Award Programs
    • Nominate
    • Previous Award Programs
    • Other Award Programs
    • Best Places to Work in Healthcare Logo for Navigation
      Nominations Open - Best Places to Work in Healthcare
      Nominations Open - 50 Most Influential Clinical Executives
    • 100 Most Influential People
    • 50 Most Influential Clinical Executives
    • Best Places to Work in Healthcare
    • Health Care Hall of Fame
    • Healthcare Marketing Impact Awards
    • Top 25 Emerging Leaders
    • Top 25 Innovators
    • Minorities in Healthcare
      • - Luminaries
      • - Top 25 Minority Leaders
      • - Minorities to Watch
    • Women in Healthcare
      • - Luminaries
      • - Top 25 Women Leaders
      • - Women to Watch
    • Excellence in Nursing Awards
    • Design Awards
    • Top 25 COOs in Healthcare
    • 100 Top Hospitals
    • ACHE Awards
  • Events
    • Conferences
    • Galas
    • Webinars
    • COVID-19 Event Tracker
    • podium march webinar logo lockup
      Sponsored Content Provided By Podium
      Webinar: Critical Touchpoints for Every Patient’s Journey — How Technology Plays an Important Role
      scp health logo lockup march 2021
      Sponsored Content Provided By SCP Health
      Webinar: COVID’s call to action — Reset for success in 2021
    • Women Leaders in Healthcare Conference
    • Social Determinants of Health Symposium
    • Healthcare Transformation Summit
    • Leadership Symposium
    • Virtual Briefings
      • - Hospital of the Future
      • - Mental Health
      • - Patient Safety & Quality
      • - Strategic Marketing
      • - Virtual Health
      • - Workplace of the Future
    • Best Places to Work Awards Gala
    • Health Care Hall of Fame Gala
    • Top 25 Minority Leaders Gala
    • Top 25 Women Leaders Gala
  • Listen
    • Podcast - Next Up
    • Podcast - Beyond the Byline
    • Sponsored Podcast - Healthcare Insider
    • Video Series - The Check Up
    • Sponsored Video Series - One on One
    • Next Up Podcast: Educating patients on the COVID-19 vaccine with Tanya Andreadis
      Dr. Joseph Cacchione
      Next Up Podcast: Educating patients on the COVID-19 vaccine with Dr. Joseph Cacchione
      Dr. Karen DeSalvo
      Next Up Podcast: What to expect with telehealth and healthcare technology in the next four years
      Carter Dredge
      Next Up Podcast: Ready, set, innovate! Innovation and disruption in healthcare
    • Beyond the Byline: Insurers are betting on virtual-first plans as COVID-19 shifts care pathways
      Beyond the Byline: How residents' stories shape our coverage of the vaccination rollout in nursing homes
      Beyond the Byline: Regulators aim to boost value push with fraud and abuse law updates
      An older man wearing a mask receiving a vaccine.
      Beyond the Byline: Verifying information on the chaotic COVID-19 vaccine rollout
    • Outreach during COVID-19
      Leading intention promote diversity and inclusion
      Introducing Healthcare Insider Podcast
    • The Check Up: Dr. Marc Boom
      The Check Up: Dr. Marc Boom of Houston Methodist
      The Check Up: Dr. Imran Andrabi
      The Check Up: Dr. Imran Andrabi of ThedaCare
      The Check Up: Tanya Blackmon
      The Check Up: Tanya Blackmon of Novant Health
      The Check Up: Dr. Patrick Hwu
      The Check Up: Dr. Patrick Hwu of the Moffitt Cancer Center
    • ivana naeymi-rad one on one intelligent medical objects
      Video: Ivana Naeymi Rad of Intelligent Medical Objects
  • MORE +
    • Advertise
    • Media Kit
    • Newsletters
    • Jobs
    • People on the Move
    • Reprints & Licensing
MENU
Breadcrumb
  1. Home
  2. Providers
March 26, 2016 01:00 AM

Why patients still need EMTALA

Harris Meyer
  • Tweet
  • Share
  • Share
  • Email
  • More
    Print
    AP PHOTO
    Lawmakers watch closely as President Ronald Reagan signs into law on April 7, 1986 an omnibus budget law that included the EMTALA legislation. From near left are Senate Majority Leader Robert Dole (R-Kan.); Rep. Raymond McGrath (R-N.Y.); Rep. Dan Rostenkowski (D-Ill.); Rep. Frank Guarini (D-N.J.); Sen. Russell Long (D-La.); Rep. William Coyne (D-Pa.); and Rep. John Duncan (R-Tenn.).

    In September 2012, a man arrived in the emergency department at Bon Secours St. Francis Health System in Greenville, S.C., after being shot in the leg during a robbery. A few months later, in February 2013, another man came to the same St. Francis ED after being shot in the abdomen at a club. In both cases, the hospital didn't provide stabilizing treatment because the on-call specialist declined to come in and evaluate the patients. It transferred the patients to another hospital.

    This past December, Bon Secours St. Francis agreed to pay a $100,000 civil penalty to settle allegations that it violated the federal Emergency Medical Treatment and Active Labor Act (EMTALA) by improperly transferring the two gunshot victims, even though it had the capacity to treat them. The benefits of the transfer did not outweigh the risks and unnecessarily placed their health at further risk, according to HHS' Office of Inspector General.

    Spurred by the federal investigation, the hospital's administrators, physicians and staff launched an initiative to improve the ED's trauma processes and internal communication. Everyone was instructed on hospital and physician responsibilities under EMTALA. The hospital formed a multidisciplinary trauma committee to regularly review emergency and transfer cases, improve processes for treating patients quickly, and strengthen collaboration between ED staff and specialty surgeons.

    MH Takeaways

    The unfunded mandate signed into law by President Ronald Reagan sharply reduced cases of hospitals refusing to treat ED patients without insurance. Experts blame poor communication and inadequate training for most of the remaining incidents.

    “Our physicians have taken full ownership of this process and agreed that when a physician is on call, they call back to the ED within 15 minutes and they have boots on the ground at the patient's bedside within an hour,” said Dr. Saria Saccocio, the hospital's chief medical officer.

    All of that happened because of a law signed 30 years ago by President Ronald Reagan. Congress passed EMTALA, known as the patient anti-dumping law, in response to national outrage over a surge in community hospitals transferring unstable emergency patients—including women in labor—to public hospitals and academic medical hospitals, largely for financial reasons.

    It was the first federal legislation establishing an affirmative right to healthcare, albeit a limited one. Experts say the law remains essential in ensuring that people receive basic treatment for emergencies, since tens of millions of Americans remain uninsured or underinsured despite the coverage expansions under the Affordable Care Act.

    EMTALA requires Medicare-participating hospitals to screen patients for emergency medical conditions and provide stabilizing treatment, regardless of their ability to pay. Hospitals with specialized capabilities must accept appropriate transfers to provide stabilizing treatment. The law does not require providers to continue treating patients once they are stable, nor does it generally apply after someone is admitted as an inpatient.

    Hospitals found in violation of the law potentially face a $50,000 civil fine per incident, and can be barred from the Medicare and Medicaid programs. The law also gives dumped patients or their families the right to sue the provider.

    Sidebar: 'It was ridiculous, putting her and the baby at risk like that'

    EMTALA—whose basic requirements are posted on the walls of every hospital ED—is widely credited with sharply reducing the number of cases of hospitals dumping or avoiding uninsured or underinsured patients. “It was the first universal healthcare law,” said retired Democratic congressman Pete Stark of California, one of the authors of the bipartisan legislation. “It's done what it was meant to do—making emergency rooms open to everyone without cost.”

    “When I started practicing in 1976, I witnessed substantial economic discrimination against patients,” said Dr. Robert Bitterman, an emergency physician and attorney who advises hospitals facing EMTALA investigations. “EMTALA largely changed the very bad behavior that was going on in the 1970s and 1980s. It still happens occasionally, but this isn't common anymore.”

    Despite the law's positive impact, there continue to be hundreds of complaints each year about allegedly inappropriate transfers that potentially endanger the lives of patients facing medical emergencies.

    About 200 complaints a year are found to have merit. While that represents a tiny fraction of the more than 136 million annual emergency department visits in the U.S., there's broad agreement that the law continues to play an important role.

    “If the law went away and there were no penalties, given human nature and financial pressures, the attitude would be, 'Who cares if the patient is unstable, get 'em out of here,' ” said Dr. Mark Langdorf, a professor of clinical emergency medicine at the University of California at Irvine who co-authored a new study on EMTALA enforcement.

    The law's failure to finance its mandate is still widely resented by hospital leaders and physicians. “Hospitals are required by law to provide services, regardless of ability to pay,” said Chip Kahn, CEO of the Federation of American Hospitals, who helped draft the law as a staffer for then-Sen. David Durenberger of Minnesota. “But at the end of the day, those services have to be funded.”

    Experts say there are a variety of reasons why violations of the law continue to occur. Factors include pressure on hospitals to improve their finances, poor staff training, flawed systems and processes, communication mishaps, growing challenges in getting specialty physicians to be on-call to the ED, and a lack of inpatient beds and community resources for serving mentally ill patients.

    “Part of it is failure to follow policies and procedures, part is lack of education of medical and nursing staff,” Bitterman said. “Some hospitals just want money and are reluctant to change their ways.”

    “Hospitals take seriously their EMTALA responsibility and other responsibilities to their patients,” said Tom Nickels, executive vice president of the American Hospital Association. “Unfortunate and isolated cases result from a breakdown in communication. ... There always will be opportunities to improve communications, processes and care.”

    The impetus for EMTALA was an epidemic of patient transfers that were widely seen as inappropriate and dangerous for patients, including pregnant women in labor being turned away from emergency rooms. Studies showed that in the early 1980s, there were about 250,000 transfers a year from private hospitals to public or Veterans Health Administration hospitals.

    Nearly 90% were for economic reasons, with 24% of these patients unstable at the time of transfer. Their mortality rate was triple that of other patients. In Chicago during the 1980s, 89% of transferred patients were black or Hispanic, according to a study published in the New England Journal of Medicine.

    Public anger peaked after CBS' “60 Minutes” in 1985 broadcast tapes of phone conversations between a referring physician at a Dallas-area private hospital and officials at public Parkland Memorial Hospital, which was being asked to accept an unstable female patient. Parkland balked.

    “Don't give me all that crap. She does not have any insurance, the hospital does not want to take care of her, OK?” the doctor attempting to make the transfer said. “This is a private, capitalistic, money-making hospital. They're on my back to have her transferred.”

    Enforcement, which started slowly, gained momentum after Congress amended the law in 1989 to require facilities with specialized services to accept transfer patients. Over the years, the law became a basic feature of hospital and physician practice.

    “EMTALA is completely embedded in the way hospitals operate,” Kahn said. “When a person is sufficiently in need of care, the first question is, 'What services do we need to provide to make you stable?' Finances are second.”

    Indeed, Republican politicians who normally oppose government mandates have pointed to EMTALA when downplaying the need for federal health insurance expansion. Long before Obamacare, the law served as a safety net to ensure that people didn't die in the street. “I mean, people have access to healthcare in America,” President George W. Bush said in 2007. “After all, you just go to an emergency room.”

    But EMTALA is no guarantee of appropriate emergency care. From 2002 to 2015, the CMS conducted 6,035 investigations of EMTALA complaints against hospitals and physicians—an average of 431 a year, according to a new study in the Western Journal of Emergency Medicine. The CMS found violations in 2,436 of the complaint cases it surveyed in conjunction with state agencies—an average of 174 a year.

    To keep their Medicare certification, hospitals found in violation must submit a corrective plan, which the CMS reviews and approves. The agency then forwards those cases to the OIG for possible civil monetary penalties.

    Of the cases referred to the OIG from 2002 to 2015, 192 resulted in settlements, including eight by physicians, according to the study. The most common citations were for failure to screen (75%) and stabilize (42.7%) for emergency conditions. Patients were turned away from hospitals for financial reasons in 15.6% of cases.

    David Wright, a CMS deputy regional administrator who has handled EMTALA cases for more than 20 years, said most violations involve hospitals refusing to accept appropriate transfers from facilities that lack the capability to screen and stabilize the patient's emergency condition. “It's either an individual action or it's something driven by resource constraints hospitals face,” he said.

    Many EMTALA violators do not receive fines and those cases are not publicly reported by the OIG, said Sandra Sands, a senior attorney with the OIG who has been handling EMTALA cases since 1989. “The cases we report on the Internet are among the worst cases, but they aren't the only bad cases,” she said. “We don't have the resources to pursue every case.”

    Settlements in 2014 and 2015 included two cases where the patients died, according to the OIG. A settlement in December by Lake City Medical Center in Florida, an HCA facility, involved a patient who a hospital staffer determined did not need immediate medical attention. Police were called to escort the patient out of the ED even though she had vomited and complained of arm pain. She was taken to another hospital where she was placed on a ventilator in the ICU and diagnosed with bacterial meningitis.

    Lake City Medical Center self-reported the case. Corrective action included staff termination, EMTALA education for all ED and registration staff, and training for the hospital's senior managers and nursing supervisors, according to a hospital spokeswoman.

    In October 2014, the DCH Medical Center in Tuscaloosa, Ala., paid $40,000 to settle a case involving a gunshot victim, for whom the emergency physician called the on-call general surgeon to help. According to the OIG, the surgeon said he was busy performing previously scheduled elective procedures. No other surgeon was available.

    After waiting two hours, the patient died without having received an evaluation or stabilizing treatment. The hospital declined to comment on the case, saying there is pending civil litigation.

    A number of cases reported by the OIG involved patients with psychiatric emergencies. Between 2011 and 2014, the OIG reported fining five hospitals for such violations, including a $180,000 settlement in 2012 with Duke University Health System, Durham, N.C., for allegedly failing to accept five transfers of patients with unstable psychiatric emergency conditions.

    Dr. Marc Futernick, president of the California chapter of the American College of Emergency Physicians, said lack of EMTALA enforcement in psychiatric emergency cases is a big problem. His ED often holds psychiatric patients for many days because psychiatric units at many Los Angeles-area hospitals conduct financial screening and won't accept patients for stabilization who are uninsured or on Medi-Cal. “You can't send these hospitals a patient without insurance,” he said.

    A growing issue in recent years has been the refusal of many physicians to accept emergency on-call duty, particularly in specialties such as trauma surgery, orthopedics, ophthalmology, neurosurgery and hand surgery. Hospitals are required to have appropriate specialists available to screen and stabilize ED patients. But Bitterman said specialists increasingly avoid call panels because many emergency patients are uninsured or underinsured, ED calls disrupt their private practice schedule, and they don't want to be summoned in the middle of the night.

    Despite these failures, even critics acknowledge EMTALA has changed hospital and medical culture for the better. A case settled by Santa Rosa (Calif.) Memorial Hospital for $50,000 in December illustrates how the law has heightened awareness and spurred hospitals to correct serious problems in how they handle patients in emergencies.

    In September 2011, Santa Rosa, a part of St. Joseph Health System, allegedly failed to respond when notified several times that a homeless man who had just been treated for alcohol withdrawal and discharged was lying on the edge of the hospital parking lot, according to the OIG. The man, identified in news reports as Michael Torres, was later found dead of acute bacterial pneumonia.

    The hospital conducted a full review of the case and offered to share the information with Torres' family. In a letter to the community, the hospital's then-CEO, Kevin Klockenga, admitted his organization “did not act as expeditiously as we could have to obtain ambulance assistance.” The hospital subsequently retrained staff to improve policies and processes for getting needed assistance to people in distress on the hospital's grounds, conducted mock drills, and consulted with local social-service agencies to better address the needs of homeless people.

    Klockenga wrote to the family to “express our heartfelt sorrow over the death of Mr. Torres and vow to improve our own processes, as well as take a leadership role in improving care for the homeless in our community.”

    “People's lives are being saved” by the law, said the OIG's Sands. “When a hospital calls and says, 'I need you to take care of this patient,' hospitals say 'yes' because they realize that otherwise, they would be violating federal law. The statute makes a very big difference every single day.”

    Correction: The caption on the photo above has been updated to indicate that President Ronald Reagan signed the Consolidated Omnibus Budget Reconciliation Act containing EMTALA legislation on April 7, 1986.

    Letter
    to the
    Editor

    Send us a letter

    Have an opinion about this story? Click here to submit a Letter to the Editor, and we may publish it in print.

    Recommended for You
    The Check Up: Dr. Marc Boom of Houston Methodist
    The Check Up: Dr. Marc Boom of Houston Methodist
    Q&A: Houston Methodist CEO praises staff efforts to keep vaccine efforts going during ice storm
    Q&A: Houston Methodist CEO praises staff efforts to keep vaccine efforts going during ice storm
    Sponsored Content
    Get Free Newsletters

    Sign up for free enewsletters and alerts to receive breaking news and in-depth coverage of healthcare events and trends, as they happen, right to your inbox.

    Subscribe Today

    The weekly magazine, websites, research and databases provide a powerful and all-encompassing industry presence. We help you make informed business decisions and lead your organizations to success.

    Subscribe
    Connect with Us
    • LinkedIn
    • Twitter
    • Facebook
    • RSS
    • Instagram

    Stay Connected

    Join the conversation with Modern Healthcare through our social media pages

    MDHC_Logotype_white
    Contact Us

    (877) 812-1581

    Email us

     

    Resources
    • Contact Us
    • Advertise with Us
    • Ad Choices Ad Choices
    • Sitemap
    Editorial Dept
    • Submission Guidelines
    • Code of Ethics
    • Awards
    • About Us
    Legal
    • Terms and Conditions
    • Privacy Policy
    • Privacy Request
    Modern Healthcare
    Copyright © 1996-2021. Crain Communications, Inc. All Rights Reserved.
    • News
      • This Week's News
      • COVID-19
      • Providers
      • Insurance
      • Government
      • Finance
      • Technology
      • Safety & Quality
      • People
      • Regional News
        • Midwest
        • Northeast
        • South
        • West
      • Digital Edition
    • Insights
      • ACA 10 Years After
      • Best Practices
      • Special Reports
      • Innovations
    • Transformation
      • Patients
      • Operations
      • Care Delivery
      • Payment
    • Data/Lists
      • Rankings/Lists
      • Interactive Databases
      • Data Points
    • Op-Ed
      • Bold Moves
      • Breaking Bias
      • Commentaries
      • Letters
      • Vital Signs Blog
      • From the Editor
    • Awards
      • Award Programs
        • 100 Most Influential People
        • 50 Most Influential Clinical Executives
        • Best Places to Work in Healthcare
        • Health Care Hall of Fame
        • Healthcare Marketing Impact Awards
        • Top 25 Emerging Leaders
        • Top 25 Innovators
        • Minorities in Healthcare
          • - Luminaries
          • - Top 25 Minority Leaders
          • - Minorities to Watch
        • Women in Healthcare
          • - Luminaries
          • - Top 25 Women Leaders
          • - Women to Watch
      • Nominate
      • Previous Award Programs
        • Excellence in Nursing Awards
        • Design Awards
        • Top 25 COOs in Healthcare
      • Other Award Programs
        • 100 Top Hospitals
        • ACHE Awards
    • Events
      • Conferences
        • Women Leaders in Healthcare Conference
        • Social Determinants of Health Symposium
        • Healthcare Transformation Summit
        • Leadership Symposium
        • Virtual Briefings
          • - Hospital of the Future
          • - Mental Health
          • - Patient Safety & Quality
          • - Strategic Marketing
          • - Virtual Health
          • - Workplace of the Future
      • Galas
        • Best Places to Work Awards Gala
        • Health Care Hall of Fame Gala
        • Top 25 Minority Leaders Gala
        • Top 25 Women Leaders Gala
      • Webinars
      • COVID-19 Event Tracker
    • Listen
      • Podcast - Next Up
      • Podcast - Beyond the Byline
      • Sponsored Podcast - Healthcare Insider
      • Video Series - The Check Up
      • Sponsored Video Series - One on One
    • MORE +
      • Advertise
      • Media Kit
      • Newsletters
      • Jobs
      • People on the Move
      • Reprints & Licensing