Prince George's County ER task force cites rising emergency volumes, insurer and data gaps as barriers to relief

Prince George's County ER Task Force members reviewed a near-final draft report on emergency department wait times and agreed to press hospital systems and payers for additional data and feedback.

The draft presented to the group said emergency-department volumes in the county rose 36.5% between 2020 and 2024, a trend the report linked to inadequate emergency-room treatment space, limited inpatient beds and shortages of primary and post-acute care that slow patient throughput. "The volume, for emergency room wait rooms has increased by 36.5%, 36.5%," Anya Makarova, senior adviser to the Prince George's County Council sitting as the board of health, told the task force while summarizing the analysis.

Why it matters: Task force members said the county lacks a complete picture because available statewide data exclude some freestanding urgent-care centers and do not include District of Columbia or Virginia hospital records. That gap complicates efforts to design local solutions and to quantify how many county residents seek care outside Prince George's County.

Key findings and data limitations The draft uses Health Services Cost Review Commission (HSCRC) data for inpatient and outpatient measures. Makarova said HSCRC-supplied figures allow comparison of inpatient arrival-to-admission and outpatient arrival-to-discharge times and show several county facilities above the state average for wait times.

Makarova also reported population-based measures: county residents accounted for 13.7% of local emergency-room visits in Maryland in 2024, with another 6.2% of Prince Georgians served in Maryland hospitals outside the county — together representing roughly 20% of the county population receiving ED care in Maryland. She told the group the Maryland state average is 27.5%. Makarova cautioned that those figures omit DC and Virginia data and therefore undercount total out‑of‑county use.

Task force members repeatedly raised data-quality concerns. A hospital representative identified as "Miss Brown" told the group HSCRC figures undercounted activity at some centers, and members asked that hospital systems review the draft and provide corrected historical counts for facilities that changed ownership or names.

Urgent care access and payer barriers The task force discussed urgent care as a possible diversion for low-acuity patients but found structural barriers. Bill Miller, chief executive officer of CRH Healthcare, said payers play an outsized role: a single dominant insurer can make a facility financially infeasible by withholding economically viable contracts. "If I don't have a contract from the largest payer in the state, I can't open," Miller said, describing payer contracting as a de facto gatekeeper for new urgent-care sites.

Makarova and Miller said additional barriers include Maryland Medicaid reimbursement rates and an on-site physician (MD) requirement for some facilities, which can be impractical for urgent-care staffing models that rely on nurse practitioners and physician assistants.

EMS and cross-jurisdictional transfers Members discussed analyzing emergency medical services (EMS) dispatch and disposition records to identify nonemergency 9-1-1 calls that could be diverted or handled outside the transport system. Makarova said preliminary county EMS data show a substantial share of transports go to facilities outside Prince George's County. She said assistant chief Buxton provided data indicating roughly 37% of medical transfers are taken to facilities outside the county, with many going to Washington, D.C., and northern Virginia.

Next steps and outreach Task force members agreed the next step is direct engagement with hospital systems. Makarova said she will circulate a revised draft for comment and recommended meetings with each hospital system so staff can review the numbers and provide missing data. Delegate Ashanti Martinez (Maryland state delegate, 22nd Legislative District) offered to pursue conversations with payer government-relations staff to clarify contract and network adequacy criteria; he noted, "It's Blue Cross. They are a tough nut to crack."

The group also discussed whether in-person meetings with hospitals would secure more timely responses. Erica Turner, associate deputy chief administrative officer for health, human services and education for the Prince George's County executive, offered to assist in follow-up with hospital partners.

Votes at a glance - Task force approved the meeting minutes by voice vote. The motion was moved and seconded and the chair announced the minutes were approved. (Procedural; no substantive policy action.) - A motion to adjourn the meeting was moved, seconded and carried.

The task force scheduled further hospital outreach and data follow-up. Members emphasized that final recommendations will depend on hospital-supplied, facility-level data, improved EMS disposition coding and additional cross-border emergency-usage records from DC and Virginia.