The largest medical group in Texas is a company few have heard of outside the hospital sector.
Emcare, a national leader in physician outsourcing services, is the nation’s largest emergency department (ED) contractor, according to Modern Healthcare. The nation’s 10th largest medical group has 158 offices nationally and nearly 800 physicians, according to SK&A.
The company’s first client was Baylor, which was seeking to outsource its ED physician staffing in 1972. Three decades later, Emcare provides services to more than 500 hospitals in 40 states and treats more than nine million patients annually. Its ED services include management, recruiting, billing and coding, and locum tenens physicians. It has expanded to include anesthesiology, hospitalist, and radiology services.
EmCare uses a Rapid Medical Assessment (RMA) system, which essentially creates what it calls a virtual ED expansion.
An RMA team includes a physician, registered nurse, and ED technician. EmCare designates sub-waiting rooms, some of which has recliners, for patients needing less urgent care. The nurse selects patients who could be handled more quickly because their illness required little more than what could be dealt with in a 15-minute physician-office visit. The physician evaluates the patient and may order tests or treatment. The patient occupies an ED bed for not longer than they are actively treated. Otherwise, they spend their time in the RMA sub-waiting room.
Dighton Packard, Emcare physician and chairman of the ED at BUMC, said RMA can be used in a variety of ways based on how the ED is staffed and how the department is laid out.
“But the concept is the same: RMA is used when there are more people than beds. We try to find patients who don’t need to lie down. We see them using RMA and put them in a chair. This allows us to use each bed more efficiently.
Emcare continues to staff EDs for eight Baylor acute-care hospital and eight specialty-hospitals.
Joel Allison, president and CEO of Dallas-based Baylor Health Care System, said, “Emcare was the first (company) to create a model I consider the gold standard (in ED care). As EDs become major points of access for patients, getting adequate physician coverage is a priority for patient satisfaction and care. Emcare has moved ED care to the next level.”
Allison said Emcare has elevated the quality and consistency of ED medicine throughout the entire Baylor system.
