It’s no secret that going to the doctor can be expensive, but visiting an emergency room can be even more costly. In the U.S., one of the largest areas of consumer spending is on health care. According to the National Center for Health Statistics, 136 million people in the U.S. visited an emergency room (ER) last year, and each of those ER visits on average cost around $3,712, per a 2015 Milliman Report.
According to Truven Health Analytics, more than 70 percent of emergency department visits from patients with employer-sponsored insurance coverage are for non-emergency conditions or conditions easily preventable through simple outpatient care.
What is an emergency room? An ER is a health facility that’s open 24 hours a day 365 days a year and staffed by board certified physicians to treat emergency conditions. No appointment is necessary, and wait times are typically 30 minutes (CDC) but can be up to two hours. Patients are billed the emergency room copay designated by the insurance plan they have. Patients may also be required to pre-pay a deductible designated by the insurance provider.
“A significant number of all ER episodes – 44-65 percent – are urgent care treatable, which means the injury or illness isn’t serious enough to require an ER visit. The lack of public education and the massive growth in private health care facilities creates confusion when patients are forced to make a decision on their health care choices,” says Dr. Jay Woody, co-founder of Legacy ER & Urgent Care, a 24/7 emergency and urgent care medical services center with locations throughout North Texas.
By understanding what other health care facilities are available other than a freestanding or hospital based ER, consumers can reduce their medical costs and save themselves thousands of dollars on out-of-pocket costs, premiums and deductibles. Two alternate facilities consumers can go to for health care services are an urgent care clinic and a hybrid emergency room clinic.
What is an urgent care clinic? These are walk-in clinics that focus on treating non-life threatening illnesses that require immediate care but aren’t serious enough for an ER. Most but not all urgent care clinics are staffed by a physician, physician assistants, advanced practice clinicians and nurse practitioners who work independent shifts. These clinics are not required to have a licensed physician on staff. Normal office copays are designated by the insurance provider.
What is a dual emergency room and urgent care clinic? They are defined as a walk-in clinic offering both ER and urgent care treatment options under one roof. These clinics are typically staffed by board certified and ER-licensed physicians and have short wait times. At Legacy ER & Urgent Care, the average wait time is less than five minutes, and patients are typically released in less than one hour. Patients are billed based on if their health issue is diagnosed as an ER or urgent care case. This allows patients to only pay for the care they need.
Hybrid care facilities like Legacy ER & Urgent Care offer ER and urgent care services under one roof and take a different approach to healthcare. At Legacy ER & Urgent Care, patients meet with board-certified and ER-licensed physicians who review their health issue and determine if they need to be treated as an ER patient or as an urgent care patient. Patients are billed accordingly, allowing them to only pay for the care they need.
“Freestanding and hospital-based emergency rooms only have one level of billing and that is at an expensive ER level which includes a facility fee and multiple arbitrary billing opportunities for supplies or procedures. It’s integral that consumers understand that they can get their injuries and illnesses treated for a lower cost at a hybrid care or urgent care facility,” Woody explains.
Legacy ER & Urgent Care’s hybrid care model allows them to be more efficient, more cost effective and more focused on the patient.
“Our unique hybrid approach is important because it could be the difference between a patient paying a small copay (urgent care) or a high deductible (ER) for the same services at a traditional emergency room, where you get billed for ER services no matter what,” he adds.
Founded in 2008, Legacy ER & Urgent Care is one of the nation’s first health care models to offer both urgent care and emergency room treatment options under one roof. It has built an exceptional customer service program and rating by providing transparent billing, soothing environments and one-on-one service with board-certified, emergency-trained physicians. Patients have access to immediate, on-site emergency room equipment and only pay emergency care prices when it is truly an emergency.