For-profit emergency rooms draw patients, and anger
These stand-alone facilities are spreading in affluent communities, but hospitals and insurance companies see them as unfair competitors.
They're known as free-standing or stand-alone emergency rooms, and they're springing up in some unlikely places -- like next to the tanning salon at the local suburban strip mall. These for-profit ERs aren't attached to hospitals, and unlike the more common urgent-care centers, they can handle life-threatening issues like a heart attack or stroke.
Geared toward affluent communities, stand-alone ERs are convenient -- but at a cost. The final bill at one of these facilities, according to the Denver Post, can end up being four to five times more than at an urgent care center or clinic.
They're also coming under intense criticism from hospitals, urgent care centers and insurance companies that see stand-alone ERs as both competition and a financial strain on the overall cost of medical care.
Companies such as Texas-based First Choice Emergency Room, however, position themselves as an alternative to overburdened hospitals. First Choice has 16 facilities in Texas and is expanding its operations into Colorado.
Stand-alone ERs started in the 1990s in rural areas but have caught on as hospital ERs have become overwhelmed with patients. Ambulances don't bring patients to stand-alone ERs, and patients requiring hospitalization, surgery or a specialist's care are transferred by contracted ambulance from a free-standing ER to a regular hospital.
Reports say the number of stand-alone ERs has doubled in the past four years to more than 400 nationally.
The Federal Emergency Medical Treatment & Labor Act (EMTALA) guarantees the public has access to emergency services regardless of their ability to pay, and that includes the freestanding ERs. But critics say the for-profit facilities specifically target well-insured consumers because in most circumstances insurance companies have to pay for ER visits if the patient believes he's having a medical emergency.
Patients at stand-alone ERs can also be charged very expensive facility fees on top of the physician's costs, which often get passed on to the insurer.
That's drawing the ire of the insurance sector. Bloomberg reports Aetna (AET) has sued several free-standing ERs for "wrongfully submitted facility fees." The insurance giant also claimed the for-profit ERs are businesses that have "masqueraded as hospital emergency rooms, without a license or any of the associated overhead."
Insurance companies are also expecting some patients, suffering sticker shock after a visit to a free-standing ER, to think twice next time.
"There's a learning curve on the patient's part," Dr. Elizabeth Kraft, chief medical officer for Anthem's Blue Cross insurance in Colorado (the parent company of Blue Cross is WellPoint (WLP)) told the Denver Post, "and they may get a bigger financial hit than they were expecting."
A free standing, for profit ER should be able to provide services cheaper than a hospital ER. They overhead should be less and in affluent neighborhoods this business model should attract less of those unable or unwilling to pay. The insurance companies are probably mad as they are having to really insure people now and the insurance company has not figured out yet how to screw the free standing ER services.
I don't understand the problem. If I break a glass doing dishes and need to get stitched up, or my son falls off the jungle gym and breaks his arm, Blue Cross is fine if I wait for 4-5 hours at a hospital ER, but they have a problem with paying the same amount to the stand alone ER where I might wait 20-30 minutes? It's still an emergency, it's still a physician who will assess the situation. And my going there allows for the hospital ER to have better quality of care for more severe cases that might require hospitalization.
Isn't this good for everyone?
BTW calling them "for profit" is just an attempt to get a rise out of the "common man" because there are plenty of hospitals that are operated as "for profit" businesses.
Correct me if I'm wrong, but I thought that most insurers have a network of participating facilities. They can say up front: "We do not cover emergencies if you go to one of these facilities - they are out of our network and you're on your own if you choose to go there". That's part of the contract between the insurance company and the insured. Problem solved. It's my decision whether I want to go within-network or out-of-network, and the financial consequences are on me.
The insurance companies should not be complaining as long as they make it clear that they will not cover services rendered in these facilities. If hospitals are complaining, maybe they need to wake up and take a page from these new facilities. As RUstpd said, free market.
Wow... MSN showing bias. This is exactly the model we are going to be seeing in the future. And I do not believe a word about the costs. The very model dictates that the costs are much lower for a free-standing facility. What the Lib morons don't realize about "free" healthcare is it is NOT free!!!!!!
The reason a typical Hospital ER visit is so expensive is you are helping to pay for the other half of the patients in the waiting room next to you that have no insurance! Refer back to the article -
"The Federal Emergency Medical Treatment & Labor Act () guarantees the public has access to emergency services regardless of their ability to pay,". Says it all. 15-30 million illegals???
Do the math. We are toast!
So they prefer them to operate at a loss???
An ER, Hospital, Doctors private practice, even the insurance companies operate at "A PROFIT". They are a business. They must cover payrolls, expenses, utilities etc etc just like any other business. If they operate at a loss they lose quality staff and eventually close.
That's what has occurred here in southern Arizona. The cost of mandates government care for illegal aliens has bankrupted many local medical facilities so they went out of business or relocated away from the area so now paying customers have to drive to Tucson or Phoenix for care.
Good for them. This is where healthcare is going in the U.S. Medicare doesn't pay for the true cost of medical services anymore. 10,000 doctors per the WSJ article this week have stopped taking Medicare patients since 2006. Doctors will get around Obamacare by a fee based system. You need a heart transplant? $200,000. Kidney $150,000. It's come to this because of big government.
Nice job AARP in screwing your members.
Having trouble seeing this as a liberal complaint. It states that well-insured, more affluent people seem to be the ones complaining the most. Those usually aren't liberals. Where are you reading that?
I've been in insurance for 41 years, & can say with absolute confidence that for-profit insurance companies have absolutely no business providing health care. Some things can't be operated on a for profit basis, like orphanages, disaster relief, the United States Marine Corps, & our health care.
I've asked before, but received no reply - how does the CEO's yacht, or the board chairman's private jet improve out health care?
sounds to me more like the regular hospitals and their exploding bills are coming up short so they piss and moan about other greedy hospitals who are cutting their revenues
the rich and greedy will always argue money
+ why would someone want to pay 4 to 5 times more in a bill
something doesn't sound right to me either or
one thing it reminds me of is a leach and a mosquitoe
who can get more blood money
I certainly wouldn't pay that price insurance or not
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