Annual ER visits have increased 34% between 1995 and 2010, with emergency department visits reaching 130.4 million. Americans are becoming more concerned about how much emergency care costs. Patients spend hours of their time in emergency rooms due to significant overcrowding and spend some additional hundreds (or thousands) of dollars for the visit. Wait times in urban areas can be over an hour, not even including treatment time. The average cost of an ER visit is somewhere around $2,168, although some patients pay much more.
Why Costs Are High
Despite medical insurance, patients are being billed for services believed to be covered, especially in emergency rooms. Frequently, emergency physicians are part of an independent group working out of the hospital, and therefore their services are billed separately from the hospital’s. While the hospital you attend may be “in-network” with your insurance, the physician group taking care of you may not. There is a law in place that states you cannot be billed more for attending an emergency room out-of-network, however the physician group can bill you for whatever your insurance does not pay. This practice is called balance billing and can lead to substantial, intimidating medical bills for patients.
Patients are frequently surprised with high medical bills. For example, a North Texas mother was surprised with a bill of $6,000 because one of her doctors was out-of-network at an in-network hospital. Unfortunately, this is a common occurrence across the country – hefty bills affect even those who are insured. According to Centers for Medicare and Medicaid Services (CMS), about 50% of emergency visits still go uncompensated.
Per the Kaiser Family Foundation, approximately 28.5 million non-elderly Americans remain uninsured. So many Americans remain uninsured because of the exorbitant cost of the insurance itself. Due to increasing copays and deductibles for those with insurance, outpatient testing and specialist visits often get delayed or even ignored.
Because patients choose to delay care, more emergency rooms are seeing patients with chronic conditions who present worsening symptoms and complications. This isn’t because they have inadequate doctors, but because the necessary care they need is unaffordable. When problems worsen, patients rush to the ER for illnesses that could have been prevented by normal doctor visits.
Urgent Care vs. Emergency Rooms
Urgent care centers are becoming more popular because of their convenience and lower costs. For the average insured patient, the average cost is around $45 and for self-pay around $185. Most urgent cares accept a majority of insurances, and typically charge significantly lower co-pays than emergency rooms.
