Emergency Room Tag

Urgent-Claims-Up
Insurance claims for urgent care visits grew by 1,725% between 2007 and 2016—more than seven times the growth rate of claims for emergency room visits, according to new data from FAIR Health. The FH Medical Price Index and FH Healthcare Indicators reports also reveal that the median price for an urgent care visit is lower than the cost of new-patient visits to office-based physicians ($242 vs $294, respectively). Fair Health based its data on over 25 billion privately billed healthcare claims. Its reports reflect a broadening of choices for patients,Read More
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UnitedHealthcare (UHC) just launched a new protocol for evaluating emergency room claims that it says will encourage accurate coding by providers and ultimately bring down healthcare costs. Some hospitals view it as just another way to deny claims, however—and one that could actually end up costing patients more money, at that. Under the policy that took effect on March 1, UHC reviews and maintains the right to adjust or deny claims for ED visits coded at Level 4 or Level 5 for patients covered through United’s commercial and Medicare AdvantageRead More

Posted On January 30, 2018By Stuart WilliamsIn Industry

Mercy Stresses the Urgent Care Option as ED Volume Swells

Like many facilities across the country, Mercy Hospital in Fort Smith, AR wrestles with overcrowding in the emergency room, especially during flu season. In addition to higher patient volume, resources are further stretched due to staff calling in sick in greater numbers. The administration is dealing with the crisis by employing all available resources, including making the most of the flexibility of the urgent care model. Mercy has dedicated one location specifically to patients presenting with flu-like symptoms; this not only allows them to be seen faster, but also keepsRead More
Hospitals and health systems have been taking a hard look at how they can maintain financial stability in recent years. As you’ve read here, many are venturing into urgent care, both on and off campus. Now, some are taking another step toward becoming everyday community health providers by offering, essentially, primary care in their emergency rooms. An article in Modern Healthcare details how one of them, Carolinas Healthcare System, realized the same old way of conducting hospital business was unsustainable. The answer, they hope, would be taking a broader lookRead More

Posted On August 15, 2017By Stuart WilliamsIn Payers

Follow-up: AMA Cries Foul over New Anthem ED Policy

We’ve told you recently about plans some insurers have to stick patients with the bill for emergency room visits that are retrospectively determined to have been nonemergent in nature. In essence, if patients go to the ED with an illness or injury that could have been handled in a lower-acuity setting (such as an urgent care center), as determined by the insurer, the patient’s claim will be denied. Now the American Medical Association is demanding that Anthem Blue Cross Blue Shield, for one, rescind that policy immediately in states whereRead More

Posted On August 4, 2017By Stuart WilliamsIn Practice

Consider What Else Might Be Going on with Sunburn Patients

Patients who seek care for sunburn in emergency rooms and urgent care centers often have complicating concerns—some of which have little directly to do with the sunburn, according to a new report published in JAMA Dermatology. Psychiatric illness (9.3% of cases), alcohol use (6.4%), and homelessness (6.4%) were among the more common, according to researchers from Brigham & Women’s Hospital, Massachusetts General Hospital, and associated urgent care clinics. More closely linked with sunburn were blistering (37.3%), constitutional symptoms (18.6%), and secondary infections (1%). Regardless of any coexisting symptoms, NSAIDs, acetaminophenRead More
Barely more than a third of children brought to an urgent care center or emergency room with anaphylaxis have received epinephrine before arriving, according to a new study published in the Annals of Allergy, Asthma, and Immunology. According to the report, which reflects the cases of 408 children with an average age of 7.25 years, just 36% of the patients had received epinephrine before reporting to an urgent care center or ED. The odds were much higher for children whose reaction occurred in school (61%) than at home (31%). TheRead More
The University of Colorado Cancer Center in Aurora, CO has quantified just how much urgent care can contribute to the overall health of patients with cancer—and it’s considerable. The Clinical Assessment and Rapid Evaluation (CARE) Clinic within the cancer center helped keep 21% of cancer patients out of the emergency room, generating over $176,000 in revenue over a period of 7 months. There’s no telling how many potentially serious complications were prevented by saving immunocompromised cancer patients from the risk of sitting in the ED waiting room for hours. TheRead More

Posted On May 24, 2017By Stuart WilliamsIn Industry

ED Wait Times Shorten After Telemedicine is Added

The emergency room at the Washington (DC) Hospital Center had a statistically validated reputation for long waits—more than 115 minutes, on average. They’ve managed to lop an hour off that, though, thanks to a new telemedicine system that’s helped reduce clutter and time waiting to be seen. Employing a system called Teletriage, by EmOpti, the MedStar-owned facility now uses video to allow providers to see a patient remotely during the triage process. Triage nurses start ordering tests and certain medications while patients wait for a full, in-person physical. Now averageRead More
Brooklyn (NY) Borough President Eric Adams has a message for basketball fans, concert goers, and cinephiles in his native environs: Stay out of the emergency room unless you absolutely have to be there; the urgent care center is often a much better, faster, and less costly option. Adams is so keen on that message that he recorded a series of public service announcements that play in the Barclays Center arena and high-end movie theaters in Brooklyn, among other locales. In one of the videos, which features a split-screen image ofRead More