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Why is an ER fundamentally so much more expensive than another office visit? Just an anecdote, I don’t see any late night “urgent care” places anymore. If they

Why is an ER fundamentally so much more expensive than another office visit? Just an anecdote, I don’t see any late night “urgent care” places anymore. If they were sufficiently less expensive than ERs, it seems like insurance companies would incentivize them to have longer hours. Otherwise, after 9pm, you have to go to ER.

mlyle 3y ago
> Why is an ER fundamentally so much more expensive than another office visit? Two main reasons: you need to use personnel, equipment, and rooms that can offer the highest levels of care. And you need to pay for having a facility staffed to handle worst case loading (with triage) 24/7. You also tend to have pretty exhaustive testing on the "emergent" side to make sure everything is immediately OK prior to discharge.
- nradov 3y ago
  Right, and ERs also charge high prices to insured patients in an attempt to recoup losses from treating uninsured patients (including those with serious chronic mental disorders).
  - katbyte 3y ago
    Even here in Canada where all citizens generally have insurance ER visits are still far more expensive then if a patient visits a primary care provider or has has any sort of care before the issue takes them to the ER
  - jmye 3y ago
    This has vastly less to do with the cost than the level of care they have to be prepared to provide. I get that people really want to beat the medical cost horse, but it’s sometimes helpful to understand it, first. People use the ED as a PCP across the spectrum because they don’t know better, because they can’t find other options, and sometimes because they don’t have other options - and all of those things tend to cost the hospital, state or insurer vastly more than the patient. Further, tacking on “serious chronic mental disorders” is basically a non-sequitur and could’ve been replaced with “diabetes” or “broken legs” or “tooth pain”.
- deleted 3y ago
  [deleted]
darkerside 3y ago
If they were staffed like an ER, they would cost as much as an ER. On top of us already paying for an ER.
- thfuran 3y ago
  Urgent care is never going to be staffed and equipped the same as an ER. It's not an ER. If you get shot, the ambulance isn't going to take you to an urgent care.
jmye 3y ago
They are significantly less expensive - there are also massive doctor/nurse shortages, among other issues. Insurers, especially in the MA space but also in the ACA market, spend a significant amount of time trying to educate ED users about UCCs. If your local urgent care can’t find a doctor or NP willing to be on call late, they can’t stay open late. Given the shortages, expect the problem to get worse.

mlyle 3y ago

> Why is an ER fundamentally so much more expensive than another office visit? Two main reasons: you need to use personnel, equipment, and rooms that can offer the highest levels of care. And you need to pay for having a facility staffed to handle worst case loading (with triage) 24/7. You also tend to have pretty exhaustive testing on the "emergent" side to make sure everything is immediately OK prior to discharge.

nradov 3y ago
Right, and ERs also charge high prices to insured patients in an attempt to recoup losses from treating uninsured patients (including those with serious chronic mental disorders).
- katbyte 3y ago
  Even here in Canada where all citizens generally have insurance ER visits are still far more expensive then if a patient visits a primary care provider or has has any sort of care before the issue takes them to the ER
- jmye 3y ago
  This has vastly less to do with the cost than the level of care they have to be prepared to provide. I get that people really want to beat the medical cost horse, but it’s sometimes helpful to understand it, first. People use the ED as a PCP across the spectrum because they don’t know better, because they can’t find other options, and sometimes because they don’t have other options - and all of those things tend to cost the hospital, state or insurer vastly more than the patient. Further, tacking on “serious chronic mental disorders” is basically a non-sequitur and could’ve been replaced with “diabetes” or “broken legs” or “tooth pain”.
deleted 3y ago
[deleted]

darkerside 3y ago

If they were staffed like an ER, they would cost as much as an ER. On top of us already paying for an ER.

thfuran 3y ago
Urgent care is never going to be staffed and equipped the same as an ER. It's not an ER. If you get shot, the ambulance isn't going to take you to an urgent care.

jmye 3y ago

They are significantly less expensive - there are also massive doctor/nurse shortages, among other issues. Insurers, especially in the MA space but also in the ACA market, spend a significant amount of time trying to educate ED users about UCCs. If your local urgent care can’t find a doctor or NP willing to be on call late, they can’t stay open late. Given the shortages, expect the problem to get worse.