Emergency departments across the U.S. are facing a growing crisis—one that’s pushing the system to a breaking point. A sharp rise in patient volume, chronic staff shortages, and increasingly aggressive payer behavior are placing unprecedented strain on frontline providers. A recent study from the RAND Corporation confirms what many in healthcare already fear: the emergency care safety net is unraveling.
Over five years—including periods before and after the No Surprises Act—the study shows a troubling financial trajectory. In-network physician reimbursement has dropped by 11%, while out-of-network rates have plummeted by nearly 48%. At the same time, uncompensated care has surged. These shifts are not only financially unsustainable—they’re leaving emergency physicians trapped in a cycle of moral injury, treating higher acuity patients with fewer resources.
If you’ve seen the hit series The Pitt, you’ve gotten a taste of the emotional weight borne by emergency clinicians. But fiction can’t match the urgency of the real-world crisis. In this powerful episode of Zotec Answers, Ed Gaines, Vice President of Regulatory Affairs at Zotec Partners, talks with Dr. Jennifer Raley, Managing Partner at Wake Emergency Physicians, PA, Chair-elect of the Emergency Department Practice Management Association (EDPMA), and Chair of EDPMA PAC. Together, they break down the RAND study’s findings and expose the deepening fracture in our healthcare system.
This is more than a policy issue—it’s a human issue. From frontline burnout to broken reimbursement models, Dr. Raley and Ed provide a real-life glimpse into the challenges facing emergency care and call on healthcare professionals, lawmakers, and industry leaders to take action. Tune in to understand what’s at stake—and what must change.
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