Many emergency room (ER) visits are not actually emergencies at all and could be treated more quickly and efficiently -- and for less money -- at urgent care centers, retail care centers, or at a primary care provider’s office. The average cost of an ER visit is $1,200 and comes with an average wait time of four hours or longer.
Most of us know that the ER is far from the most efficient place to get care. And when only 11 percent of visits to the ER result in a hospital admission, it’s pretty clear there’s a problem. Not to mention that 65 percent of ER visits aren’t even true emergencies and many conditions could be treated by a primary care doctor within the next 12 hours. A recent study indicated that treating many of these ER non-emergencies at urgent care or retail clinics could save $4.4 billion.
Those statistics don’t just add up to a headache for health care providers and our members’ wallets, but it puts a tremendous strain on the health care industry overall—to the tune of more than $400 million a year.
Since 2014, ER visits have increased 27 percent among Blue Cross NC members who have their coverage through the Affordable Care Act’s (ACA’s) marketplace. The increase in unnecessary ER visits definitely contributed to Blue Cross and Blue Shield of North Carolina (Blue Cross NC) having to request a larger premium increase from members enrolled in our ACA plans for 2016. The overall cost of care for our ACA members has exceeded the payments we expect to receive (from members and the government) by $123 million.
The Right Care at the Right Time and in the Right Place
Urgent care centers like FastMed Urgent Care are an economical and efficient alternative for non-emergency care that can save members both time and money. The average cost of an urgent care visit is $60, which is a substantial savings for patients when compared to the cost of an ER visit—not to mention the wait time at an urgent care clinic is usually just 15 to 45 minutes.*
Health care cannot look like it has for the past 20 years. A sustainable future requires that we work together to make health care better by delivering more value to health care consumers. The consequences of not working together to ensure that patients get the care they need at the right time and in the right place include higher medical care costs for all concerned, fragmented patient care, and crowded ERs that translate into reduced access to care for those in true need of ER services.
*Urgent Care Benchmarking Study—Journal of Urgent Care Medicine, January 2012)