Redesigning the Emergency Department for 15 Million Newly Uninsured: Financial and Operational Strategies to Strengthen Flow

Emergency Departments have long been the front door of the hospital — and the pressure valve for everything upstream and downstream. Yet today, EDs nationwide are facing unprecedented strain from growing patient volumes, staffing shortages, and downstream boarding challenges that ripple across the system. 

Now, new policy shocks threaten to intensify these pressures, with an estimated 15 million people projected to lose Medicaid coverage by 2034 and turn to emergency care as their primary access point.

The financial stakes are staggering: $12 billion lost annually from ED boarding across the US, $10,000-$20,000 lost per patient on average from declined transfers, and $2,000 lost per patient per day from extended lengths of stay.

In this discussion, financial and operational leaders will share how they are aligning financial strategy, technology investments, and operational redesign to strengthen ED performance. Together, they’ll discuss how thoughtful coordination between finance and operations can reduce leakage, improve throughput, and create the stability hospitals need to weather growing access challenges.

Learning objectives:

• Understand the financial impact of ED boarding and access bottlenecks — and how system-level investments can mitigate revenue loss and strengthen margins.
• Explore how aligning operational and financial strategies can reduce inefficiencies, improve throughput, and expand patient access.
• Learn how predictive technologies and data-driven planning support more agile staffing and resource allocation.
• Gain a cross-functional perspective on how finance and operations leaders are partnering to stabilize the “front door” of the hospital amid rising demand and shifting payer dynamics.