Why Urgent Care and Not ER Facilities?
Hopefully, you saw the ER vs Urgent Care pull-out in last month’s issue of the Grapevine – maybe it’s stuck on your refrigerator door right now or maybe you are wondering what this is all about and if LAFRA is just trying to save a few bucks?
The answer – we are trying to educate the membership to save you from additional, unnecessary out of pocket expense.
Urgent care centers are walk-in medical facilities that provide care on a no-appointment basis and are often open for extended hours, including nights and weekends. These centers are a cost-effective alternative to emergency rooms for the treatment of non-life-threatening medical situations such as cuts, sprains, simple bone fractures, flus and fevers, insect bites, infections, etc. Some centers provide basic laboratory and X-ray services, and most can run diagnostic tests and dispense prescriptions. If you pre-plan your primary care needs and use an urgent care center that is a PPO facility, normally you will only pay your $15 co-pay for care at these facilities. This is a Win-Win situation for you and your member-owned medical plan.
Hospital Ambulatory Medical Care Survey estimates that one-third to one-half of all ER visits are for non-urgent care. In fact, the top three reasons for ER visits were for superficial injuries and contusions, sprains and strains, and upper respiratory infections. The CDC defines non-urgent as “needing care in 2 to 24 hours.”
It is estimated that more than $18 billion could be saved annually if those patients whose medical problems are considered “avoidable” or “non-urgent” were to take advantage of primary or preventive health care and not rely on ER’s for their non-emergency medical needs. ER costs correspond to the severity of a patient’s illness or injury, the number of diagnostic tests and/or treatments performed, physicians’ fees (typically about 20-25 percent of the total charges), radiology or specialist services, and any pharmacy or other hospital expenses – all of which can add up quickly.
It is also important to know that even if the hospital ER is a Preferred Provider Organization (PPO), the physician and other service providers may not be.
If you do have a true medical emergency, call 911 or go to the nearest hospital emergency room.
Don’t Waste Your Time!
Have you seen the billboards along the freeway that read: Text ER to 23456 for Average Wait Times? This is very misleading. The problem (besides texting while driving) is that the ER will provide you with an average wait time – NOT how long you are going to wait at that moment. And more importantly, it will cost you more money to use an Emergency Room.
ER wait times tend to be noticeably long—and getting longer. In 2009, average wait times reached 58 minutes, up from 47 minutes in 2003, according to a CDC report. In addition, patients are triaged at arrival and are then seen by a qualified medical professional in priority order based on their presenting complaint and reason for visit.
The Urgent Care Association of America’s 2010 Urgent Care Benchmarking Report surveyed nearly 1,700 urgent care centers and found that about 65% of patients wait less than 20 minutes to see a provider. Overall, the report noted a decrease in wait times and that wait times shift throughout the day—with shorter wait times during the mid-day hours, and longer wait times in the morning and evening hours.
By Dave Wagner