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Update on Funding for Trauma Readiness





The Trauma Center Association of America (TCAA) is aware of recent media reports raising concerns about the cost of “trauma fees.”  While each episode of care has unique circumstances and TCAA does not have details beyond the media reports, the reports have prompted an important conversation about how we pay for trauma care in the U.S. TCAA is not a standard-setting body; our role is providing counsel to our members on trauma center operations including best practices in billing, administration, practice guidelines, and other areas relevant to trauma centers, including federal reimbursement and advocacy. TCAA strongly supports adequate and appropriate reimbursement for the critical services provided by trauma centers across the nation.


By design, trauma centers treat all injured patients regardless of their clinical or economic needs. Trauma centers, like fire and police departments, are available 24 hours a day, 7 days a week. Trauma centers treat all aspects of injury. At all times, they must have the full roster of emergency services available, ranging from the entire spectrum of surgical specialists to radiologists, lab technicians to respiratory specialists, and beyond.


This level of commitment by trauma centers coupled with the public expectation for high quality care requires trauma centers to make considerable investments in readiness. The cost of readiness is expended regardless of the patient volume or insurance status. Trauma centers have considerable costs that are not captured by traditional billing and reimbursement, creating a significant financial challenge in ensuring trauma readiness.  Trauma centers care for all victims of traumatic injury, regardless of their ability to pay and thus have significant uncompensated care.


Trauma centers and the services they provide are a unique and necessary component of our health system. The risk of death for a severely injured trauma patient treated at the highest Level I Trauma Center is 25% less than in a non-trauma center hospital.  For those severely injured in motor vehicle crashes, initial triage to a non-trauma center increases the risk of death within the first 48 hours by at least 30%.


TCAA supports robust, predictable federal funding streams dedicated to the investments required to ensure trauma centers have the facilities and personnel they need.  We are working closely with Congress, as part of the Pandemic All-Hazards Preparedness Act (PAHPA), on creating and clarifying the resources available to trauma centers for this purpose and to ensure that they can continue to provide patients with excellent care.  In addition, we are actively engaged with the Centers for Medicare and Medicaid Services (CMS) on ways to improve reimbursement policy to more accurately reflect the costs of trauma readiness.

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