Emergency care: Urgent care, freestanding ERs on the rise

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The Affordable Care Act was supposed to reduce the use of emergency departments as newly insured Americans chose primary care physicians. But ERs are busier than ever.

In a piece for Hospital & Health Networks, healthcare futurist Ian Morrison, Ph.D., examines the emerging trends in emergency care--specifically the ER use at a new California hospital, as well as the rapid growth of urgent care centers and free-standing ERs.

Ian Morrison

Morrison sits on the board of Martin Luther King, Jr. Community Hospital, the 131-bed acute care hospital in Southern California that opened in 2015. The hospital features a 21-bed ER, which has logged 70,000 visits since it opened its doors. One reason for the influx of patients is because the community hospital is located in an area that had limited access to primary and specialty care, Morrison writes.

To keep patients out of the ED, many organizations have opened urgent care centers. Most are open late and charge a third of what the visit would cost in an ED. Waiting times are generally shorter.

Free-standing ERs are also gaining momentum. The latest statistics indicate there are more than 500 of these stand-alone facilities in the country and industry experts project there could soon be as many as 2,000.

RELATED: Freestanding ERs may freeze out poor, minorities

Unlike urgent care centers, these facilities are open 24/7. They typically charge standard ER rates and provide more sophisticated diagnostic equipment than urgent care centers, such as X-ray machines, CT scanners and labs. But they are often located in affluent communities, which have a high percentage of patients with private insurance.

Morrison frets they are cherry-picking patients.

“I think we should be careful that freestanding emergency departments do not become a metaphor for the health system more broadly,” he writes.