What is a freestanding emergency room?

Transcription

1 What is a freestanding emergency room? How this article can help you: This article will tell you what a freestanding emergency room is, what it treats, and how it differs from a hospital emergency room or an urgent care. What is a freestanding emergency room? Also known as: Freestanding emergency rooms Freestanding emergency room departments Standalone emergency departments Most emergency departments are physically attached to a hospital. Freestanding emergency departments (FSEDs) are not. FSEDs have been around since the 1970s. At first, FSEDs were meant to serve people who didn t have great access to emergency medical care, such as people living in rural areas. In the past ten years, they have been showing up in areas with more people, such as the suburbs. Today, there are more than 400 FSEDs in more than 45 states. (1) FSEDs are like regular hospital emergency rooms because they treat medical emergencies. FSEDs have many of the same services you d find in a regular hospital room, including: Lab services Common radiology services (x- rays, CT scans, and ultrasounds) Like hospital emergency rooms, FSEDs are generally open 24 hours a day, 365 days a year. Most, but not all, FSEDs must treat anyone who comes through their doors, regardless if the person can pay or not. (2) FSEDs are staffed by emergency room physicians and nurses that are trained in emergency medicine. (2) They are run by hospitals, doctors, or non- medical entrepreneurs. Some people like FSEDs because they can be quicker than hospital emergency departments. (3) But there are some important differences between FSEDs and hospital emergency departments that you should know about. Read on to learn more about what FSEDs treat and whether they are right for you.

2 How is a freestanding emergency department different from a hospital emergency department? FSEDs are different from hospital emergency rooms because: They are not attached to a hospital. FSEDs are able to handle some but not all medical emergencies. If you need surgery, specialist care, or if you need to be hospitalized, the FSED will send you to a hospital. You may have to pay to be transported to the hospital. (3) They may not have access to every specialist available in a hospital ER. Specialists are doctors who are experts in a specific area of medicine. In a hospital emergency room, doctors and nurses can call a specialist if they need an expert opinion to treat someone. For example, if a person with diabetes comes into a regular emergency room with chest pain, doctors and nurses can call a diabetes doctor and a heart doctor if they need more help or knowledge. Doctors and nurses working in a FSED might not be able to call on a specialist if they need to. (3) They may not take Medicare and Medicaid. Free- standing ERs are not obligated to accept Medicare and Medicaid. If you are planning on visiting a FSED, you should ask if they take your insurance prior to your visit. Why are freestanding emergency departments just as expensive as hospital emergency departments? When you go to a hospital emergency department, you pay for the treatment you get and a facility fee. The hospital charges each patient a facility fee. The reason hospitals charge patients facility fees is because it s very expensive to run a hospital. (4) Facility fees are meant to pay for many things hospitals need, including: Care for people who can t pay 24 hour a day service New equipment and technology Administration (5)(6) FSEDs also charge a facility fee. Some people think this charge is unfair, since it costs much less to operate an FSED than it does to operate a hospital emergency room. Some health insurance companies have argued that payment of a facility fee to some of these facilities is illegal and there are on- going lawsuits. (7)

3 How is a freestanding emergency room different from an urgent care? People often confuse urgent cares and FSEDs because they look alike and provide many of the same services. But there are important differences between the two facilities you should know about: Important differences between urgent cares and FSEDs Operating hours Treat Staff Laboratory capabilities Imaging capabilities Urgent Cares Usually open hours a day, 7 days a week. Non- life threatening illness and injury, like sprains, minor infections, flu symptoms, rash, cuts, and broken bones. Doctors, physician assistants (PAs), nurse practitioners (NPs), medical assistants and technicians. Varies by location. Most urgent cares can perform simple labs at the urgent care. More advanced labs are usually sent out to experts. X- ray. Medical assistants or radiology technicians. Source: Urgent Care Association of America (2) FSEDs Most are open 24 hours a day, 365 days a year, though some are open hours a day, 7 days a week. Some, but not all, medical emergencies. Emergency medicine trained doctors, emergency nurses, medical assistants and technicians. FSEDs have more lab capabilities than urgent cares, but less than hospital emergency rooms. They have a laboratory technician on staff. X- ray, CT scan, ultrasound. FSEDs usually have a radiologist on call to read images. When should I go to a freestanding emergency room? If you are experiencing a life- threatening emergency, call 911. To learn more about whether your situation is truly an emergency, read our article: When should I go to the emergency room? If time is important to you, FSEDs are generally quicker than hospital emergency rooms. Just know that FSEDs can be just as expensive as hospital emergency

4 departments. Also know that you may be transferred to a hospital emergency room, and that you may have to pay the costs of transportation yourself and potentially another ER fee. Also, realize that your health insurer may not endorse certain FSEDs. It s possible that you may have to pay part of the bill by yourself. (3) If your injury or illness is not life threatening, consider going to an urgent care, a retail clinic, or your doctor. What you need to know about freestanding emergency rooms Each state defines and regulates FSEDs differently. Some states require that FSEDs be open 24 hours a day, 7 days a week, 365 days a year, while other states do not. Some states require that FSEDs treat anyone that walks through their doors, whether the person can pay or not. It s important that you know what your state s FSED laws are, so that you know whether a FSED is right for your medical emergency. FSEDs can cost as much as a visit to a hospital emergency room. Like hospitals, FSEDs charge the people they treat a facility fee. Also, if you go to a FSED and need to be transported to a hospital, you may have to pay for the transportation yourself. (3) Your insurance may not pay for treatment at a FSED. You may have to pay the cost of going to one by yourself. (7) Make sure you know your options in your area. Since FSEDs can be expensive, and may not be able to treat your medical emergency, make sure you know all your emergency care options near your work, home and school. That way, if you are experiencing a medical emergency, you can make an informed decision about where to go. Make sure you know what a real medical emergency is. Many people do not know how to recognize a medical emergency, and waste time and money in a hospital emergency department or a FSED. If you know how to recognize a true medical emergency, you can avoid wasting time and money. Know your insurance. If you think that you may need to go to a FSED at some point, call your insurance and ask if they pay FSEDs. The bottom line: FSEDs ARE NOT the same as hospital emergency departments, and they ARE NOT the same as urgent cares. FSEDs can be faster and more convenient than hospital emergency departments, but they can be just as expensive. If you re dealing with a medical emergency, your best bet is to call 911.

5 If you re not dealing with a medical emergency, but something urgent, consider going to an urgent care if your symptoms are not very severe. Urgent cares are much cheaper than visits to an emergency room, whether it s a hospital emergency department or a FSED. Medically reviewed by itriage clinicians Article sources 1. New York State Department of Health. Free Standing Emergency Departments. New York State Department of Health. Available at: uncil/meetings/ /docs/feds_background.pdf. Accessed: May 28, Ayers, A. Emerging Business Models: Freestanding Emergency Rooms. Available at: 3. California HealthCare Foundation. Freestanding Emergency Departments: Do They Have a Role in California? Available at: emergency- departments- do- they- have- a- role- in- california. 4. Boodman, Sandra G. Facility Fees Are Surprise Cost For Many Patients. Kaiser Health News. October 6, Available at: 5. Galewitz, Phil. Wildfire Growth of Freestanding ERs Raises Concerns About Cost. Kaiser Health News. July 15, Available at: alone- emergency- rooms.aspx. 6. Freyer, Felice J. Health Insight: Don t be blindsided by doctors facility fees. Providence Journal. January 4, Available at: health- insight- dont- be- blindsided- by- doctors- facility- fees.ece. Accessed: May 28, Maat, Sue Ter. Freestanding emergency department growth creates backlash. American Medical News. April 29, Available at: