After developing a chest cold and breathing problems last year, Susan Alexander went to First Choice ER, an independent emergency room in League City, Texas, drawn by its motto: “Real ER. Real Fast.”
Treatment was indeed speedy, about 20 minutes. It was also real expensive, Alexander said. The bill was about $2,000, or as much as five times what the 56-year-old nurse might have paid for similar care at a doctor’s office. The charges included a $1,518 “facility fee,” typically assessed by hospitals and their ERs to support the space, services and equipment needed to keep dozens to hundreds of beds available.
Yet First Choice looks nothing like a hospital. It sits in a single-story commercial building that shares parking space with a hair salon and an energy company. Alexander was left with an out-of-pocket bill of about $700.
“I was astonished,” she said in a telephone interview. “It’s a rip off.”
Freestanding ERs are among the fastest-growing areas of medical care, often offering 24-hour service, minimal waits, board-certified emergency specialists and complex testing technology. Proponents say they provide a safety-valve for overcrowded and understaffed hospital ERs. Critics worry they will make care more expensive for those not seriously ill, adding to national medical costs expected to rise to $3 trillion in 2014 and undercutting efforts by the 2010 health care law to reduce payments for individual medical services.
First Choice and other stand-alone ERs say consumers should expect charges on par with those in hospitals because the service it offers is similar.
“We’re an ER,” First Choice spokeswoman Heather Weimer said in a telephone interview. “That means it will cost more. We don’t try to hide it.”
Alexander’s case was “atypical,” according to Weimer. It required a chest X-ray, steroid and breathing treatment and took longer than 20 minutes, she said. First Choice had no control over her out-of-pocket costs since that was based on what her insurer covers, Weimer said.