What Most Healthcare Providers Won’t Tell You

Believing that health care costs should be as transparent as possible to consumers, North Texas’ Legacy ER & Urgent Care has created the ER Savings Initiative. The goal of the ER Savings Initiative is three pronged: first, to engage with consumers, alerting them to avoidable medical expenses; second, to encourage straightforward and honest billing; and third, to promote healthy facility utilization from its health care competitors.

Based on extensive research, the ER Savings Initiative employs a value-based healthcare mindset while revealing the true cost of visiting an emergency room versus visiting an urgent care facility. According to the Center for Medicare and Medicaid Services, the per capita expenditure for healthcare is approaching $10,000 each year. Yet, the ER Savings Initiative reveals that a large portion of those costs could be avoided if consumers are well informed.

A Truven* analytics study, in conjunction with a Milliman** study sponsored by Legacy ER & Urgent Care, reveals the following statistics for the Dallas MSA:

• The average cost of an urgent care case is $226.

• The average cost of an ER case is $3,712.

• The average cost of an ER case that doesn’t require emergency care and could be treated at an urgent care center is $2,039.

• For every 1,000 insured individuals, approximately 203 of them will visit an emergency room.

• 44–65 percent of ER cases are actually urgent care treatable.

Consider this case study: a patient with strep throat (which is not typically an emergency room case) who goes to an urgent care facility for diagnosis and treatment will leave with an average bill of $226. But if that same patient visits an ER for strep throat, costs could exceed $2,000.

“With the growing number of freestanding ER units, the big issue for consumers is understanding where to go,” says Dr. Jay Woody, co-founder and chief medical officer of Legacy ER & Urgent Care. “The average consumer only discovers the difference between urgent, acute and emergency care when they receive their bill. From a marketing standpoint, these terms are nothing but synonyms and this is just bad business. This is exactly why we started Legacy ER & Urgent Care, so that our customers don’t have to choose or self-diagnose themselves and will always be placed as patients above profits. Period.”

On the patient side, consumers need to do their due diligence when it comes to searching for healthcare facilities. Uninformed consumers are urged to take the following steps to avoid unnecessary costs:

1. Self-education – Knowing the difference between urgent care, ER, retail care and freestanding ER can save money and time, not to mention the assurance that they are visiting facilities congruent with their medical needs.

2. Patients must save emergency room visits for true emergencies only – 40-65 percent of ER cases are actually urgent care treatable, meaning patients currently incur higher costs by going to the ER when it’s unnecessary.

3. Visit hybrid model facilities – while hybrid model facilities like Legacy ER & Urgent Care are few and far between, they will begin to increase in popularity as consumers begin the self-education process. However, these will not grow in number as fast as freestanding ERs as the profit margin for hybrid facilities is much lower because patients receive urgent care bills for non-emergency. These facilities are ideal, as their unique ability to bill both urgent care and ER based on what the patient needs, eliminating the guesswork behind deciding which kind of facility visit is truly necessary.

Not only does this research impact patients, but it plays a vital role in the future of healthcare facilities in general. Health care consumerism will be a driving force behind patient care in the years to come. As patients become more educated on their options, they will likely choose facilities where they can get the best service for the lowest price. Facilities that transition into transparent billing practices during this time period will be successful.

Facilities will also begin considering facility utilization. Understanding where costs are necessary and where they aren’t allows facilities to operate more efficiently. For example, though Legacy ER & Urgent Care offers both ER and urgent care billing, the facility categorizes – on average – 80 percent of the cases that come through its doors as urgent care and only 20 percent as emergency.

Legacy’s ER Savings Initiative campaign aims to set the standard for billing and facility processes in the future. The overuse of emergency has been an issue for far too long. Encouraging patients to do their own due diligence and research while facilities adopt a more fair billing practice will certainly improve the future of healthcare.

For more information, visit http://legacyer.com/, facebook.com/LegacyERandUrgentCare or twitter.com/legacyertx.

*2013 Truven study: Avoidable Emergency Department Usage Study

*2015 Milliman White Paper: Potential Saving When Moving from an Emergency Department to an Urgent Care Setting in Commercial Populations (for Dallas MSA)

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Founded in 2008, Legacy ER & Urgent Care is one of the nation’s first health care models to offer both urgent care and emergency room treatment options under one roof. It has built an exceptional customer service program and rating by providing transparent billing, soothing environments and one-on-one service with board-certified, emergency-trained physicians. Patients have access to immediate, on-site emergency room equipment and only pay emergency care prices when it is truly an emergency.

Jeff Cheatham

TrizCom PR

O: 972-247-1369

Nikki Darling

TrizCom PR

O: 972-247-1369

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