Hospitals increasingly are asking patients who visit emergency departments with non-emergent ailments to pay an upfront fee before they can receive any medical care, according to industry data and observers, Kaiser Health News/Washington Post reports.
The fees -- which can cost as much as $350, depending on the hospital -- are levied once the patient has undergone a federally mandated pre-treatment screening, according to the KHN/Post. Some hospital executives say the fees have helped reduce overcrowding in their EDs and encourage staff to make appropriate use of scarce resources.
According to CDC, roughly 8% of ED visits are considered non-emergent and involve problems that can be addressed in a physician office or clinic, but other analyses have suggested a higher rate. ED physician groups have warned against the pay-first policy, noting that some patients might decide to forgo treatment altogether, which potentially could heighten the problem.
David Seaberg, president of the American College of Emergency Physicians, noted that 2% to 7% patients who have been screened at an ED and do not have a serious problem are hospitalized within 24 hours. In addition, patient advocates warn that the policy might discourage patients with health emergencies from going to the ED.
However, hospital executives say the policy is in response to rising bad debt as more uninsured and underinsured seek medical care in EDs. In addition, the policy helps reduce costs for some private and government insurers for patients who depend on EDs for routine care (Galewitz, Kaiser Health News/Washington Post, 2/18).