"The pendulum has swung. In the 1990s and the early 2000s being a trauma center was a money-losing prospect. So, the healthcare system has created some incentives to ensure access to trauma center care," he said.
Financial Incentives and Trauma Centers
"Now a lot of states will pay fairly large trauma team activation fees. It has created an incentive where trauma centers can make money by collecting these fees. So a number of these smaller Level 2 and 3 trauma centers have been popping up in some areas in the South and that has become a problem for the larger academic trauma centers in those areas."
Brown says it's time to re-evaluate and better coordinate how trauma center designations are awarded with an eye on the effect for the entire care delivery system in a particular region.
"The way it has been done is a hospital says 'we want to be a trauma center' and there are a number of boxes they need to check. If the county goes along with this most of the time the state or the accrediting agency will say 'you can be a trauma center,'" Brown said.
"We should shift that perspective to saying 'what is the overall impact on the trauma system that you are going to be part of? Is there a population center that will support a new trauma center, or are you going to be pulling volume from other trauma centers that could develop into a net negative impact on the overall trauma system?'" Brown said. "Taking the perspective on how the whole trauma system is impacted is the way to go."
While designating trauma center status should be a better regulated process, Brown says it's a job that should remain primarily in the hands of state and local governments.
"It needs to be done on a fairly local level," he said, "but support in terms of funding and legislation at the federal level can push some of these accreditation agencies in that direction to take this kind of perspective for the way they develop their trauma systems."
John Commins is a content specialist and online news editor for HealthLeaders, a Simplify Compliance brand.