Banner
  • Revenue Cycle Management
  • COVID-19
  • Reimbursement
  • Diabetes Awareness Month
  • Risk Management
  • Patient Retention
  • Staffing
  • Medical Economics® 100th Anniversary
  • Coding and documentation
  • Business of Endocrinology
  • Telehealth
  • Physicians Financial News
  • Cybersecurity
  • Cardiovascular Clinical Consult
  • Locum Tenens, brought to you by LocumLife®
  • Weight Management
  • Business of Women's Health
  • Practice Efficiency
  • Finance and Wealth
  • EHRs
  • Remote Patient Monitoring
  • Sponsored Webinars
  • Medical Technology
  • Billing and collections
  • Acute Pain Management
  • Exclusive Content
  • Value-based Care
  • Business of Pediatrics
  • Concierge Medicine 2.0 by Castle Connolly Private Health Partners
  • Practice Growth
  • Concierge Medicine
  • Business of Cardiology
  • Implementing the Topcon Ocular Telehealth Platform
  • Malpractice
  • Influenza
  • Sexual Health
  • Chronic Conditions
  • Technology
  • Legal and Policy
  • Money
  • Opinion
  • Vaccines
  • Practice Management
  • Patient Relations
  • Careers

Free (Grand) Standing ERs

Article

Free-standing emergency rooms are growing like weeds in many affluent neighborhoods. However, some of the centers are creating problems and attracting the interest of local lawmakers.

Emergency room, medical practice entrepreneurship, practice management

are growing like weeds in affluent neighborhoods. The idea is to bring the mountain to patients. However, the phenomenon is creating problems and getting the attention of state legislators whose constituents feel misled about prices and about how free-standing ERs are different from other newly created care delivery channels like urgent care centers, advanced practice professional-run primary care clinics, and retail based clinics.

How free-standing ERs will fit into the sick-care distribution mix remains to be seen. Here are some things to watch:

1. Legislative and regulatory intervention

2. The mixed message: We’re told ERs are over-utilized and expensive. Meanwhile, billboards now beckon you to come to our convenient new ER in the strip mall nearest you.

3. Business models that are designed to maximize revenues under existing reimbursement and payment rules. Maybe, some day, we'll see offshore, tax exempt holding companies running the shows.

4. More and more patients getting angry and more in debt due to unpayable ER bills

5. The continuing lack of patient education and awareness about options and choices when they think they need care. Some should just wait out their illness (no, you can starve or feed it, but, in most cases, don't treat it with antibiotics at your retail based clinic), others can go to other less expensive options.

6. The misguided notion that most patients are good sick-care consumers

7. The failure of most ER-to-outpatient hand offs and the lack of effective physician referral management systems

8. The continued lack of transparent pricing

9. Cherry picking the highest payor mix when choosing sites

10. Truth in advertising and the patient's right to know their obligations when choosing a point of care

All these things represent opportunities for clinical entrepreneurs to create better products and patient-defined value. However, as long as we continue to let the reimbursement rules’ tail wag the care delivery model dog, expect to see that whopping bill in your mailbox because you placed your chips on the wrong number playing high stakes sick-care roulette.

Related Videos
Victor J. Dzau, MD, gives expert advice
Victor J. Dzau, MD, gives expert advice