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Freestanding ERs: Cost of Convenience

Gaurav Dhanda, PharmD
MediMedia Managed Markets

In today’s society, patience is a lost virtue. Americans do not want to wait and expect everything “now,” from social media updates to products being delivered the same day they are ordered.

The “want-it-now” mind-set is also reshaping the health care system.  Patients want to be seen right away.  Many physician offices are not readily accessible because of limited hours of operation.  Traditional scheduling may mean it takes week or even months to get an appointment. So where do people who want to see a health care provider as soon as possible go to? Some turn to urgent care centers, but in the last few years, another alternative, the freestanding ERs, has emerged.  They are increasing in popularity because they provide emergency services more quickly than traditional emergency rooms. They also have imaging services right on site.

According to a report by Fierce Healthcare, freestanding ERs, similar to regular ERs, have facilities fees which range from $800–$1,500. Imaging tests are extra. For even a relatively minor problem like a urinary tract infection, the cost could be $2,000–$3,000 when the same condition might have been treated in a physician’s office for as little as $100.

Some of people who have used freestanding ERs have paid a fee upfront of several hundred dollars and received a bill in the mail a few months later for another thousand more.

Freestanding ERs may be convenient, and people of means may prefer them to the hospital ER for good and bad reasons. The majority of these ERs are in wealthy areas and are not part of Hospital systems that participate in the Medicare and Medicaid programs. Most of the patients that go to these facilities have private insurance. Those that decide to be seen at freestanding ERs can afford the charges and want to avoid the conventional ERs within hospital systems.

But visits to the freestanding ER may contribute unnecessarily to health care spending just like visits to the traditional hospital-based ER do. In addition to whatever out-of-pocket costs the patient might be responsible for, higher spending gets reflected in premium prices.

It is up to payers and employers to educate employees on the cost differences at different locations. Concerted efforts to educate people about situations that warrant immediate attention—and those that don’t—might be beneficial as well. Doing so could lower costs for payers, employers, and patients.