A Novel Pilot Program Using Patient Incentives to Address Emergency Department Boarding and Overcrowding: A…

ObservationalAcademic emergency medicine : official journal of the Society for Academic Emergency Medicine· Jun 2026

A Novel Pilot Program Using Patient Incentives to Address Emergency Department Boarding and Overcrowding: A Retrospective Observational Study.

Nancy Glober, Diane Kuhn, Lisa Martin … Michele McCarroll

Emergency Department FlowObservationalQ1IF 2.0

Financial incentives for emergency department transfers to critical access hospitals earned strong patient satisfaction

A Novel Pilot Program Using Patient Incentives to Address Emergency Department Boarding and Overcrowding: A Retrospective Observational Study.

Nancy Glober … Michele McCarroll

Academic emergency medicine · Jun 2026 · Q1 in Emergency Medicine

Background

Emergency department (emergency department) overcrowding is a routine challenge for most hub hospitals, reported by more than 90% of emergency department medical directors several times each week.

Methods

This pilot study explored the feasibility and patient acceptability of offering financial compensation to low-acuity patients who agreed to transfer from an overcrowded emergency department to critical access hospitals.

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Results

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patients rated the transfer experience highly, on a scale where +100 is best

More results

Four eligible patients requiring medical-surgical admission participated.

Transfers included travel vouchers of $300-$500.

All transfers were completed safely without retransfer or complications, and all patients were discharged home.

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Conclusion · 1 of 2

Findings suggest that modest financial incentives may support patient-approved interfacility transfers, ease emergency department overcrowding, and enhance utilization of underused hospitals while complying with Emergency Medical Treatment and Labor Act.

Conclusion · 2 of 2

Further study of this model is warranted.

A Novel Pilot Program Using Patient Incentives to Address Emergency Department Boarding and Overcrowding: A Retrospective Observational Study.

A Novel Pilot Program Using Patient Incentives to Address Emergency Department Boarding and Overcrowding: A Retrospective Observational Study.

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