Increasing Vulnerability of Emergency Healthcare in the United States

The future of hospital-based emergency care in the United States faces significant challenges, putting its sustainability at risk. According to a comprehensive report by RAND released on April 7, 2025, efforts to evaluate the current state of emergency services reveal pressing concerns about their capacity, funding, and staff wellbeing.

Research led by Dr. Mahshid Abir of RAND in Santa Monica involved focus groups, surveys, and literature reviews to assess how emergency care is valued, what obstacles it faces, and potential funding solutions. The findings emphasize that emergency departments serve as crucial safety nets within the U.S. healthcare system. However, they are increasingly strained due to rising patient numbers, especially from 2020 to 2024, along with higher patient complexity, including medical and social needs. Increased patient acuity and limited capacity have resulted in overcrowding, extended wait times, and instances of violence against staff.

Compounding these issues is the decline in payments to physicians per emergency visit, threatening the financial viability of emergency services. The report advocates for policies that allocate local funding to emergency departments, enhance investment in primary care, and establish protections for those who require care but cannot afford it, as well as safeguards for healthcare workers.

Dr. Abir stressed that immediate action is essential to preserve these vital services. She warns that if these challenges persist unaddressed, emergency departments may face closures, and healthcare professionals could leave the field, leading to longer waits and reduced access for patients.

Overall, the report calls for systemic reforms to ensure emergency care remains a resilient and accessible component of the U.S. healthcare system, emphasizing that safeguarding emergency services benefits communities and saves lives.

Source: https://medicalxpress.com/news/2025-04-emergency-vulnerable.html