Urgent care cost less, research finds

The Dallas Morning News Business
By Sabriya Rice, Sta  Writer

Patients in Texas who felt sticker shock after a visit to an emergency room often could have saved thousands if they had gone to urgent care, a new study finds.

Whether back problems, bronchi s or abdominal pain, patients paid $1,000 or more for treatments that would have cost them under $200 in a less expensive facility.

The study published Thursday in the Annals of Emergency Medicine looked at over 16 million insurance claims submitted between 2012 and 2015, by Blue Cross and Blue Shield of Texas members in 16 Texas metropolitan areas, including Dallas-Fort Worth.

It evaluated how frequently pa ents visited hospital-based and freestanding emergency rooms vs. urgent care facilities, and for what conditions. It then compared how much consumers paid for the same claim at each location on type.

The 20 most common conditions seen at urgent care centers overlapped at a rate of 75 percent with freestanding emergency rooms, and 60 percent with hospital ERs.

Here are the top five diagnoses reported at each type of facility during the dates studied.

Patients with the same medical problems were charged 10  times more on average if they went to an emergency room instead of urgent care.

Overall, Texans were more likely to use a hospital-based emergency room or urgent care. But, use of freestanding facilities jumped 236 percent over the dates studied. The cost of ser- vices and the amount insured pa ents ultimately paid out-of-pocket also increased over time. Here’s how much the cost of services varies for 10 diagnoses:

In 2012, a visit to a freestanding ERs cost on about $400 less than a hospital. By 2015, the price was about the same. Patients who visited freestanding facilities were responsible for 32 percent of the claim in 2012 and 35 percent in 2015.

That troubled researchers, who noted local anecdotes of pa ents confusing freestanding emergency rooms with urgent care facilities and being surprised by steep bills. They suggest that policymakers consider encouraging more efficient use of freestanding emergency facilities.

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