Financial Implications for Physicians Accepting Higher Level of Care Transfers

Mark I. Langdorf, MD, MHPE; Sharon Lee, MD; Michael D. Menchine, MD, MPH


Western J Emerg Med. 2013;14(3):227-232. 

In This Article


Higher-level-of-care transfers (HLOC) to one tertiary center were found to be economically disadvantageous overall, but reimbursement varied widely among specialties. Neurosurgery and EM were reimbursed better for HLOC transfers than for all of the other patients in these specialties at this site, but HLOC transfer-patient reimbursement was worse than national benchmarks for all services. This reflects a poorer patient mix at this site than nationally. Whether the teaching and procedural value of these patients compensate for financial liability is a matter of institutional purpose and professional priority.