Dive Brief:
- Free-standing emergency centers are on the rise, with more than 400 currently operating in the United States, according to the Fort Worth Star-Telegram. These centers operate like traditional emergency rooms, complete with labs, X-ray machines and other diagnostic equipment.
- Unlike urgent care clinics, the cost of treatment at these providers is much greater. An average visit to First Choice, the biggest of these chains in the nation, is about $1,500. Many of them are not in-network with insurers. And consumers and insurance companies are questioning the necessity of such centers; Aetna has gone so far as to sue two clinics for $5.4 million in refunds.
- The clinics and fees they charge are allowed by law. They are inexpensive for hospitals to build and make more than an affiliation with other providers like primary care offices.
Dive Insight:
There appears to be some confusion among consumers about the differences between an urgent care center and a free-standing ER. Patients visit the clinics in order to avoid long lines at their primary care provider's office or when a problem occurs after hours.
Patients, however, are unhappy with the super-sized bills they receive following treatment and Aetna claimed in its lawsuit that the connection between hospitals and the facilities are a "sham" set up to charge exorbitant fees.
To avoid challenges like those brought on by Aetna, the facilities and their affiliated medical systems are going to have to be as transparent as possible. The facilities will need to avoid taking patients with minor illnesses that could be treated elsewhere less expensively. They will also need to ensure that patients are made aware of the fees in advance and know if their insurance is in-network. Transparency will be important to avoid blowback from patients and the industry.