Tennessee health agency turns down Baptist Memorial's proposal for freestanding ER
The Tennessee Health Services and Development Agency (THSDA) rejected Baptist Memorial Health Care’s application for a free-standing emergency department (ED) in Arlington, Tenn., which is near Memphis. The vote was 4-4.
Baptist Memorial and Regional One Health in Memphis filed the joint application, which reportedly had the support of the mayor and board of aldermen. Saint Francis Hospital-Bartlett, which is also interested in building a new freestanding emergency room in the community, opposed the proposal.
THSDA rejected earlier proposals from Baptist and Saint Francis in April. They are both appealing the decisions.
The application called for Baptist to license the freestanding ED with Regional One Health and Baptist entering into a joint operating agreement. It would have eight treatment rooms and cost about $10 million. Regional One Health's expertise is in treating trauma, and it also houses the area’s burn center.
Baptist, which has 21 hospitals in the Mid-South region, said its BMH-Memphis ED has reached capacity. The health system expanded the ED to serve 66,000 patient visits, but ED visits reached 66,467 visits in 2016, according to the application.
The health system said the proposal would also help the area’s safety-net hospital, Regional One Health Medical Center. That ED needed to divert patients from its doors an average of 48.5 hours per month over the last six months of 2016.
A state senator who opposed the application said she was worried her constituents would be confused, and possibly go to the free-standing ER when they needed to be in a hospital, or when they could be treated in a doctor's office. The Saint Francis CEO said in a statement the application from Baptist "does not demonstrate the orderly development of care the Arlington community needs."
Health systems have been turning more to freestanding EDs. However, since the Affordable Care Act, ER visits in some states, especially those with Medicaid expansion, have decreased as patients get insurance and visit their doctors for treatment before an ER visit is necessary. Fewer ER patients benefit overcrowded ERs, but can also mean fewer dollars flowing into the hospital.
There are more than 400 freestanding ERs in 32 states, which compete with urgent care facilities, retail clinics and convenient care clinics. Though there are more freestanding EDs, a recent Annals of Emergency Medicine study compared prices at hospital-based and freestanding ERs with urgent care facilities in Texas. The report found that ER patients paid as much as 10 times more than urgent care patients for similar diagnoses.
Freestanding ERs haven’t been a financial win for everyone. Adeptus Health, which operates freestanding ERs in four states, declared bankruptcy recently.
- Memphis Business Journal State denies Baptist's Arlington ER application