“If you build it…
…he will come.” – Voice heard by corn farmer Ray Kinsella, played by Kevin Costner, in the 1989 film Field of Dreams.
This same tagline could be used to explain the fast growing phenomenon of “freestanding/stand alone” ERs. According to Kaiser Health News, it seems that several hospital chains believe if you build these new ER boutiques, the insured patients will come (as will the profits).
These ER centers are typically located in upscale communities near high-end shopping malls, and they target consumers with private insurance. On the regulation and care delivery continuum, they fall somewhere between an Urgent Care Center and a traditional hospital-based Emergency Room. Over the last four years, the number of these entities has doubled to over 400. When marketing to the consumer, they emphasize:
This trend is hot because these freestanding ERs are able to bill like a traditional hospital-based ER. They boost profits by tacking on a “facility fee” that was originally developed to help hospitals recoup overhead, 24-hour staffing and equipment costs. Interestingly, in some jurisdictions, these centers are not required to see Medicaid or Medicare patients. A Blue Cross and Blue Shield vice president is quoted that the trend will continue because “in the affluent suburbs, there is money to be made.”
We all love speed and convenience, but there is no free lunch. Employers and carriers end up paying the tab when care is delivered in the most expensive setting. Payers and stakeholders in the health care system must do better in educating the consumer.
Call us. We can do better.