When convenience isn't worth the cost

Free standing emergency departments (FSED) – those not attached to a full hospital – have been around for decades, first appearing in rural communities in the 1970s in an attempt to increase access to care without the extreme cost to build a comprehensive hospital. Since then, FSEDs have multiplied and moved their way out of rural communities and into suburban areas, driven in many ways by the on-demand economy and the desire to drive additional profits.

After all, if a patient can go to an FSED in their neighborhood, several miles to an urgent care center, or to the other side of town for a traditional emergency department, they’re probably going to choose the option that is most convenient, rather than driving twice as far for the same care. The problem arises when the bill for that same care is more than twice as much.

The Center of Improving Value in Health Care (CIVHC) recently released data from Colorado showing the majority of visits to free standing emergency departments are not necessary and come with a price tag much higher than the patient would have paid had they gone to an appropriate point of care. CIVHC’s research showed seven of the top ten reasons for an FSED visit were for a non-life threatening event – situations where the patient could have gotten the treatment they needed through a different point of care such as an urgent care facility or their doctor’s office. To make matters worse, patients were paying as much as 880% more for the treatment of some conditions because they opted to go to the FSED over the other points of care.

Just as troubling is the top ten list of reasons people visited an urgent care center – with each of the conditions, if the patient had better access to their primary care doctor, they could have avoided the urgent care center all together!

To me, this speaks to two things: 1) the need to increase access to care, and 2) a need for greater education for patients as to what conditions warrant a trip to which point of care.

At CirrusMD we’re addressing both elements with our telemedicine platform. Our patients’ average time to connect with a doctor is cut from the national average of nearly three weeks to under three minutes. Plus, the familiarity of text messaging applied to a doctor’s appointment allows for a much better patient experience than sitting in a waiting room with other people who aren’t feeling well. Once connected with the doctor, patients can ask questions, get advice, even have a prescription written if the situation calls for it –at no additional cost to them. Our doctors don’t just guide patients to the right point of care if diagnosis and treatment can’t be completed virtually, they make sure that care happens with smart in-network referrals to specialists.

As an industry, we should all be doing more to meet the triple aim: improve health, enhance quality and lower cost.