Expensive Standalone Emergency Rooms Popping Up

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Many emergency rooms are too crowded, but hospitals are expensive to build. So why not just build more emergency rooms?

That’s the reasoning behind a slew of new free-standing ERs appearing across the country, Kaiser Health News says.

Several hospital chains are driving the boom, including HCA and WakeMed Health and Hospitals. They regard the facilities as a way to expand into new markets, generate admissions to their hospitals and reduce crowding at their hospital-based ERs.

The idea isn’t new. These were around in the early 2000s for rural areas that didn’t have a hospital nearby, The Washington Post says.

What’s new is their prevalence. There are now more than 400, more than double the number in 2009. Many are in Texas, Florida and North Carolina, KHN says. The Houston metropolitan area has the most: 41 already and 10 more coming.

They’re convenient, often faster than hospital ERs in providing care, and more expensive than the urgent care centers they resemble, USA Today says. Urgent care centers don’t have the same level of high-tech equipment and aren’t open around the clock, but can treat problems that aren’t life-threatening for far less. (Ambulances generally won’t take people who are critically ill to a stand-alone ER, and in some places won’t take them there regardless of their condition, it says.)

The insurance reimbursement for treatment of a sprained ankle at an emergency room might be $700, The Seattle Times says. That’s three to four times what it would cost in a primary care or urgent care clinic. And prices aren’t always clear.

“The ERs usually don’t disclose prices before treatment, saying they don’t know how much it will cost until they evaluate a patient,” KHN says.

Critics call these new ERs cash cows purposely built in affluent areas to milk the higher reimbursements, which could push up insurance premiums. The owners argue they’re just paying the higher costs of providing 24-hour care.

Have you ever used a free-standing emergency room? Share your experience if you have, or your thoughts if you haven’t, on our Facebook page.

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  • Baileywick

    What next, door-to-door colonoscopy?

  • lb

    Both my husband and I had to visit one of these for a bad respiratory infection in April, when we were in the process of switching primary care physicians. We had general check-up first appointments set up with our new doctor, but since we were not yet “established” patients, they could not see us quickly. I’d have rather seen a dentist for our illness than our former doctor. Our local emergency stand-alone clinic was wonderful. I was seen within fifteen minutes, and out of the door in less that an hour. I have great insurance, but the co-pay there was double what it would have been at my primary care. However, SO much less that I would have paid at a hospital ER. When my husband went a week later, and had to also have chest x-rays. That was mid-April, and if there is a separate radiology bill coming, we’ve yet to see a bill. Last week my 20 yr old daughter had to be driven into Columbia from a camp she was working at in the middle of nowhere. She had a screaming migraine that none of her meds in three days had been able to dim. She went to a hospital ER with over a 4 hour wait. We googled an ER clinic nearby that was still open ( a lot of these places here are only open until 9 at night). She walked right into the clinic, received a migraine shot and was out in an hour. Total cost after insurance: $21.81. Now, if I had something worse than a sprained ankle, would I go here over a hospital? I guess I’m old-fashioned and will still opt for the “secure” feeling of a bigger hospital. But if cost and time are an issue, and it is not an accident that insurance will fully cover with no co-pays and deductibles, I see these stand-alones as a great solution. It would also be great for all of those people who habitually go to emergency rooms for every little sniffle and cough, because they have no doctor or insurance and don’t care for the state-sponsored clinics.