Are freestanding ERs about access or profit?

Freestanding emergency departments (EDs) carry high costs despite their benefits, many of which organizations could achieve through other methods, according to the Milwaukee Journal-Sentinel.

Freestanding EDs, which are growing in popularity across the country, are widely considered a potential solution to long wait times and access issues in traditional EDs. The total number in the U.S. has grown to more than 400 in the last five years, according to the article. But critics of the model say freestanding EDs provide a much more expensive variation on urgent care.

In 2010, 7 percent of ED visits were for non-urgent care and 32.7 percent were for semi-urgent care, compared to 10.2 percent for emergency care and 1.1 percent for immediate care, with the remaining visits for urgent care. EDs do not know whether patients require emergency care until a physician or other clinician sees them, meaning the freestanding model is often more convenient, but that convenience may interfere with healthcare providers' goal of reducing non-emergency ED visits.

"It doesn't [only] have to be convenient," Dianne Kiehl, executive director of the Business Health Care Group, told the Journal-Sentinel. "If we are going to support a healthcare system totally based on convenience, we will be bankrupt." For example, Froedtert Health in the Milwaukee area has proposed adding a freestanding ED, despite the fact that the proposed site does not have major barriers to care access, according to Kiehl. Health systems' focus on suburbs, where most of the patient base usually have insurance coverage, suggests they are motivated by the model's profitability rather than responding to a community need, she said.

Although increasing access is important, Kiehl said, "there are all sorts of things that can be done," she said, such as increased use of telehealth, opening additional urgent care clinics with extended hours or being able to call a doctor after hours.

To learn more:
- here's the article

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