Aren't freestanding emergency centers extremely high-cost, especially for the uninsured?

We believe freestanding emergency centers should treat all patients, regardless of their ability to pay – and as state-licensed facilities, we are required to do so. TAFEC members treat uninsured patients no differently than hospitals do – offering hardship waivers and other reductions to accommodate patients’ financial conditions.

What is a freestanding emergency center?

A freestanding emergency center is a facility licensed by the state to provide 24-hour emergency services to patients at the same level as a hospital-based emergency room.

In most states, a licensed freestanding emergency center is a health care facility that provides emergency care, but is completely separate from an acute-care hospital. Typically, these facilities will have transfer agreements with area hospitals so they can transfer patients who need to be admitted.

Some freestanding emergency centers are owned and run by hospitals, and the hospitals operate these ERs as a department of the hospital and bill their services under the hospital’s tax ID.

Independent freestanding emergency centers may be owned by physicians or other business interests, similar to the interests that helped develop the ambulatory surgery industry. Most independent freestanding emergency centers obtain the same accreditation (JCAHO) as hospital ERs, so they meet the same standards.

Some people are concerned by facilities being physician-owned – but it was actually ER doctors who noticed the need for superior emergency medical care beyond hospital walls, i.e., freestanding emergency centers.

How are freestanding emergency centers different than hospital-based emergency rooms or urgent care centers?

Freestanding emergency centers are required to provide the same level of access and services as hospital-based emergency rooms, with the exception of trauma care. But freestanding emergency centers are often closer and wait time is consistently quicker than hospital ERs. Unlike urgent-care centers, freestanding emergency centers are required to operate 24/7 – they must be open 24 hours, have ER physicians on-site at all times, provide round-the-clock lab and imaging services, and stock medications not required for urgent-care centers. As state-licensed facilities, freestanding emergency centers must also fulfill architectural and equipment requirements, and train their staffs at a level not required of urgent-care centers.

Why are more and more patients choosing freestanding emergency centers?

Freestanding emergency centers offer a unique and vital set of benefits for patients seeking emergency medical care:

Access – Freestanding emergency centers provide access to emergency medical care for every patient who comes to them.

Quality – Freestanding emergency centers provide consummate quality of care. They are licensed, closely regulated, fully equipped for all medical emergencies and required to have an ER physician on-duty at all times.

Convenience – Freestanding emergency centers provide unparalleled convenience. They are frequently closer and wait time is consistently quicker than hospital ERs, and unlike urgent-care facilities, they are required to be open 24/7 to provide all levels of care.

Cost – Freestanding emergency centers charge equal to or less than hospital ERs for emergency care that often exceeds the hospital ER standard.

Satisfaction – Among all urgent- and emergency-care providers, Freestanding emergency centers receive the highest satisfaction scores from everyone involved – patients, physicians and staff.

Additionally, according to the American College of Emergency Room Physicians:

  • only 8% of emergency patients have non-urgent conditions;
  • emergency departments have a federal mandate to treat everyone, regardless of their ability to pay;
  • two-thirds of emergency visits occur after business hours or when the doctor’s office is closed; and
  • the growing elderly population is driving necessary access to emergency care.

Freestanding emergency centers can meet these needs while reducing hospital overcrowding and letting hospital ERs focus on taking care of the most serious cases.

Will rapid growth of these facilities cause higher insurance premiums?

More freestanding emergency centers should actually help lower insurance premiums, since they offer the same access and the same quality of care as hospital-based ERs, but represent a less costly alternative for patients not facing life-threatening emergencies. And in Texas, if a patient covered by insurance visits a freestanding emergency center that is not contracted with the payor [out of network], the facility must treat the patient and accept the same amount of reimbursement as an in-network facility.

How will "Obamacare" affect the growth of these facilities?

We believe freestanding emergency centers will continue to grow once the new health care law goes into effect. Health insurance coverage doesn’t guarantee access to care, so newly insured people can still be turned away by a physician’s office or an urgent-care facility. But state-licensed freestanding emergency centers must see every patient who comes to them – it’s the law.

Ultimately, it will up to the consumer. Under Obamacare, emergency services are one of the ten “essential health benefits” that all health insurance plans must cover – coverage for emergency services cannot require pre-authorization or limit a patient to an “in-network” facility; patients can go wherever they want without asking permission from their insurance company, and insurance must pay for it at an in-network rate. With these types of limitations lifted from consumers, we believe people will choose to go to the closest, quickest choice, which is often a freestanding emergency center.