Why are Emergency Room Visits So Expensive?

by | Nov 1, 2019 | Ridiculous Healthcare Costs | 0 comments

Emergency Room
Only 29% of expensive emergency room visits are medically necessary or unpreventable.

Emergency room visits are expensive for a variety of reasons. Continuing with our series on dissecting medical bills for learning tips, I found an article from Vox that has looked at over 1,000 emergency room bills (and they’re going to keep looking at them until the end of this year – more to come).  They initially were just looking at facility fees, which we’ve covered here before, but found a host of other things. The article summarized five big areas that make emergency room visits so expensive and here is a review of them and which ones you can avoid.  

Five Things That Make Emergency Room Visits Expensive

  1. Prices in for things the emergency room dispenses to you are likely to be quite high.  From drugs to crutches to splints and stitches, it’s all going to be much more expensive in the emergency room. Be sure to ask if it’s absolutely necessary to get it before you leave the emergency department.  Decline any medications not necessary in the emergency department and ask for a written prescription to fill at a pharmacy using an online discount service like GoodRx. Same goes for crutches, splints, etc. 
  2. Just because the hospital where the emergency department is located is in your insurance network doesn’t mean the physicians who see you are.  This is a tough one, because if you’re having an emergency you don’t exactly have the time or mental focus to research your network specifics. If you do get an out-of-network bill, try to negotiate with the group to take the insurance settlement.  
  3. Facility fee – this one rears its ugly head again.  And you get charged even if you don’t get seen. If you check in but leave before being seen, you’ll likely get the facility fee.  Again, not much to do here but protest – and see the overarching solution below.
  4. It’s tough to advocate for yourself in an emergency.  Absolutely true. Any negotiating will likely be done after the fact, which is time-consuming and confusing.  Again, see the overarching solution below. 
  5. Congress wants to do something about it.  Uh-oh. Usually, that means a law, the unintended consequences of which often make things worse.  I wouldn’t count on any relief here. 

So what can you do?  Don’t go to the emergency department!  That may sound silly, but the vast majority of visits aren’t emergencies. In fact, Becker’s Hospital Review reports that only 29% of emergency department visits required emergency care and were not preventable. The remaining visits were either for something that was urgent but was best treated in a primary care setting or did not require immediate attention.

People go to the expensive emergency room because they can’t get into their doctor, a somewhat cheaper urgent care isn’t open, or they’re not sure if something is an emergency and don’t have any quick access to any advice they trust.  A Mission Direct Primary Care membership can solve all that – prompt access to your doctor to determine whether something is an emergency or not.

Believe it or not, most broken bones, cuts requiring stitches, and other things that often get evaluated in emergency rooms can wait at least a little bit.  Asthma exacerbations and other flares of chronic diseases can be met with a treatment plan and a phone call to your doctor to manage without going to the hospital. And if you do have an emergency, your Mission Direct Primary Care doctor will be available on the other side of the visit to continue care.  

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In this regular blog series, Dr. John Hallgren will reflect on one of the many news stories that focus on the ridiculous cost of healthcare and share tips on how to be a better healthcare consumer.

John Hallgren, M.D.

John Hallgren, M.D. is the co-founder of Mission Direct Primary Care in Omaha, Nebraska. He graduated from the Uniformed Services University of the Health Sciences medical school in 1995 and has been a board-certified family physician since completing residency in 1998. He is a 26-year veteran of the U.S. Air Force and has been an assistant professor of family medicine for the University of Nebraska Medical Center and Uniformed Services University. He has several publications in such journals as American Family Physician and The Journal of Family Practice.

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