As Governing reports, freestanding ERs have become a more popular alternative for some to hospital ERs. But while they’re more convenient, they often leave patients with surprise medical bills and rarely improve health care access for the people who need it most.
There are currently 360 freestanding ERs in the U.S.—60% of which are in Colorado, Ohio and Texas.
The first facilities opened in the 1970s as a way to provide emergency care for areas that didn’t have a hospital. But in the past decade, entrepreneurs increasingly have established freestanding ERs with a more profit-focused, free-market model of health care in mind. In other words, while most older freestanding ERs accept insurance; most newer ones don’t.
A new study in the Annals of Emergency Medicine also found that most freestanding ERs are located in areas with more privately insured individuals—people who, even if they were surprised by a bill, would be more likely to pay in full.
“They’ve provided the components of emergency care, but without the big, complicated hospital system,” says Jeremiah Schuur, an emergency doctor and lead researcher on the study. “But the thing is, our health care system isn’t really a free market. People think of emergency care as a public service. It is the one guaranteed health care right given to us by law. But that’s simply not the case (with most) freestanding ERs.”
This has been especially apparent in Texas, where 73% of all freestanding ERs are private, for-profit entities and the majority of out-of-network claims are filed from a freestanding ER, according to the Texas Association of Health Plans.
In general, freestanding ERs tend to be nicer than the average ER and tend to cater to the customer, explains Jamie Dudensing, executive director of the Texas Association of Health Plans.
But that added convenience and luxury comes at a price. For example, getting treated at an urgent care clinic for an ear infection will generally run about $100. But at a freestanding ER, that same treatment could cost patients $760.
