Questions surround study showing high freestanding ER bills
- Standalone emergency rooms are popping up across the country, offering quick and convenient access to care, but many people feel stung by the high prices, the Washington Post reports. One patient’s bill for a cut that required five stitches exceeded $5,000.
- The Post story stems from a study in the Annals of Emergency Medicine (AEM), which compared prices at hospital-based and freestanding ERs with urgent care facilities in Texas. But the study was pulled over emergency physicians’ concerns about accuracy and interpretation, and is undergoing editorial review, Health Data Buzz reports.
- Currently, there are more than 400 freestanding ERs in 32 states. They compete with urgent care, retail clinics and other on-demand facilities that have sprung up in recent years as consumers look for care choices that fit their schedule and budget.
The controversial AEM study found ER patients paid as much as 10 times more than urgent care patients for similar diagnoses. It raised alarm among ER physicians, who disputed the findings.
At least one company has certainly not been swimming in profits. Adeptus Health, which operates freestanding ERs in Texas and three other states, declared bankruptcy last month, citing expenditures associated with an aggressive growth strategy.
The alternative care setting space is booming as people look for ways to cut waiting time and fit healthcare visits into busy schedules. The number of families who visited a retail clinic nearly tripled between 2007 and 2010, and from 2010 to 2012 more than half of retail clinic visits represented new utilization, according to research on that market.
With more people insured under the Affordable Care Act, overall ER volume has increased. Urgent care centers have moved in to fill the need, offering reduced wait times and less stress on ER staff and resources. There are currently about 7,100 urgent care centers in the U.S.
However, rather than reducing nonemergency visits to ERs, retail clinics have found their own niche: providing access to on-demand healthcare without the need for a primary care physician.
Studies have shown that ER visit rates have dropped in some states with Medicaid expansion since the ACA requires physicians to provide free preventive services. That can be good for hospitals where ER visits are a drain on costs. It is a struggle, however, for ER companies that rely on a steady stream of patients for revenues.