A SYSTEM IN
CONTINUED CRISIS:
CMA’s Annual
ER Losses Report
September 2004
A System in Continued Crisis: CMA’s 4th Annual ER Losses Report
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The emergency and trauma system in California is “on the verge of a
whole series of unraveling events…No place is safe when you have
large volumes of people who need care, but there’s no one to pay for it.”
—Dr. Jack Lewin, CEO, CMA, New York Times, Aug. 21, 2004
n January 2001, the California Medical Association issued its first report detailing
financial losses in California’s emergency medical care system. Since that report, losses
have escalated dramatically, with red ink mounting at emergency rooms that remain
open, while others have closed their doors to patients forever, most citing financial
difficulty. In a little more than a decade, more than 65 emergency rooms have closed.
Hospital emergency room losses reached $460,087,627 in fiscal year 2001-2002 (the most
recent year for which data is available). In addition to hospital losses, physician financial losses
in those emergency departments totaled more than $175 million. Total losses—for both
ER departments and emergency room/on-call physicians—reached more than $635 million,
an 18% increase over the previous fiscal year.
Historical Comparison of ER Losses
in California Hospitals (1996-2002)
$300
$317
$325
$460
$292
$390
$200
$250
$300
$350
$400
$450
$500
1996-97
1997-98
1998-99
1999-00
2000-01
2001-02
Financial Loss (Millions)
The losses were felt across the state, in urban, rural, and suburban areas, with 79% of hospitals that
reported data to the state experiencing losses in their emergency departments. The average loss at
those facilities was $80 every time a patient sought treatment in an emergency room.
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A System in Continued Crisis: CMA’s 4th Annual ER Losses Report
Historical Comparison of ER Losses
in California Hospitals (1996-2002)
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These losses strike at the very heart of our health care
syst