THE CHALLENGE

The Growing Financial Burden of Trauma Care

Trauma centers provide lifesaving care for patients suffering severe injuries, with motor vehicle accidents remaining one of the leading causes of serious injury and death among Americans. Studies have shown that severely injured patients treated at designated trauma centers experience mortality reductions of up to 25% compared with those treated at non-trauma hospitals.

At the same time, the financial burden of traumatic injury remains significant. The National Highway Traffic Safety Administration estimates that motor vehicle crashes alone result in approximately $340 billion in annual economic costs nationwide. As uncompensated care, workforce shortages, and operating expenses continue to rise, many trauma centers can no longer rely solely on traditional federal and state funding sources to sustain critical services.

The Emergency Trauma Fund (ETF) was established to help address this challenge by providing supplemental reimbursement for qualified uninsured and underinsured trauma cases. While ETF is not intended to cover all uncompensated care, it helps trauma centers recover a portion of these costs, strengthening their ability to maintain access to essential trauma services for the communities they serve.

WHO MAY QUALIFY – ELIGIBLE FACILITIES

Eligible Facilities May Include

Funding eligibility is determined through the application review process.

Requirements

• Emergency and Trauma Provider must first complete the application (ETF or EPF) and submit it.
• Have a fully executed HIPAA Agreement between the facility/provider and ETF. ETF will accept the provider’s HIPAA Agreement.
• ETF will make the determination regarding claims that are eligible for consideration for funding.
• ETF’s consideration is limited to emergency and trauma patients that do not qualify for any other funding services, and the provider has used best efforts to determine that there is no private, health plan, federal or third-party source of potential payment. For a claim to be considered for funding, the following criteria must be met:
  • The patient is unable or unwilling to pay for services rendered to them.
  • The patient has no private health coverage or any form of coverage at time of trauma.
  • The patient is not covered by any federally funded program which includes Medicare, Medicaid or Medi-Cal or the VA.

Billing Efforts of Bad and / or Uncollectable Debt

Provider’s accounts to be reviewed for the purpose of funding shall not include any outstanding balances for claimants covered by federal Medicare programs, or a state funded Medicaid program or any other federal or state health care program, as such persons are excluded from the Emergency Trauma Fund program consideration.

Further provider must have used best efforts to qualify the person with any available state Medicaid program as well as any and all other payor sources. Provider has exhausted all efforts to collect directly from the person for the health care services provided to them during their stay. Finally, all efforts to get reimbursed by the person have ceased and the provider has assigned the account to bad debt or as uncollectible.

Provider offered a reduced amount, a percentage of billed charges to the patient without any results.

If provider received actual written notification from the patient or the patient’s representative that no payment will be made for the services provided this information should be conveyed to ETF.

Provider must exhaust all sources for payment on patient’s claim and stand that no payment will be forthcoming from a third-party or from any federal, state or commercial health plan and that provider has not received any payment related to the claim.

Funding

EPF shall issue funds to provider within 15 business days of the approval of a claim. Payment to the provider shall be only for the provider’s trauma services.

All claims paid by ETF will be considered a purchase of the receivable and all payments are accepted as full and final with all rights and remedies assigned to ETF.