Healthcare costs are outrageous and opaque. Healthcare does not follow the patterns of your standard consumer product. There are so many layers and so many veils covering up the true cost of care that I would bet most of the time, not even those providing the care know how much something might cost or exactly how much any given insurance company is going to cover of that cost.
On the extreme side of the spectrum is emergency department use. Emergency departments as mandated by the government are not allowed to turn people away based on lack of insurance, whereas, all other private practitioners may. Depending on the geographic region and availability of services, utilization of the emergency room for minor non-emergency care will vary. But all across the country, hospitals attempt to cover costs and maintain profitability by cost shifting. By cost shifting, hospitals increase charges across the board for all or the most commonly performed procedures, in order to cover the cost for those that do not or cannot pay for care. Throw in some profit margins for shareholders, and this results in the average cost of care for an emergency visit to be massively inflated compared to the cost of materials and staff that it takes to perform that care. This is particularly true for those using the emergency department for non-emergency reasons.
Colorado had 1.8 million visits to its emergency departments throughout the state in 2015, the last year full data is available. That same year, a 2015 Colorado Health Access Survey from the Colorado Health Institute surveyed over 10,000 households across the entire state and found that of those that had visited an emergency room, 40.2% knew that their conditions could have been treated by a regular doctor and they were not having an emergency but went anyway. The top four reasons for going to the emergency room for a non-emergency were: 1) It was after normal operating hours at the doctor's office. 2) The appointment for the doctor was not as soon as it was thought one was needed 3) It was more convenient to go to the emergency department and 4) The doctor's office or clinic was called but they were told to go to the emergency department anyway.
If it was decided to go elsewhere other than an emergency department for non-emergency care, the cost to the patient and to the healthcare system in general could be greatly reduced. Let's assume those patients decide to go to a retail clinic, doctor's office, or urgent care for a relatively minor complaint such as cold symptoms. Under normal circumstances, those type of medical visits for a new patient take between 10 and 20 minutes of time spent receiving some sort of evaluation from medical staff. Using the insurance claims paid data from healthcarebluebook.com other published sources and plugging in a local zip code we get various prices for that level of service.
A regular doctor's office visit would cost between $86 - $146 for the visit charge. A visit to a local retail clinic like those in some grocery, pharmacy or mega-department stores would cost between $89 - $119 for the visit. An urgent care visit will cost about $186 for minor care. And the emergency department will cost between $664 and $1331 or even more because saying words like "I feel like I can't breathe"(because the nose is stuffed up) or "My throat feels sore" can be spun up into a higher level "emergency" workup in some situations.
These costs do not take into account the hassle and time costs. A recent set of data from a national telemedicine provider, calculated that the average in-person doctor visit takes about 121 minutes including travel time, waiting room, forms and the actual visit. When time is money, based on economic data, they estimate that an in-person visit costs an extra $43 worth of your time in addition to the above mentioned costs.
Compare the costs in the preceding section with what is available through a telemedicine visit. You are being seen by an experienced physician, nurse practitioner, or physician assistant who is well accustomed to evaluating and treating non-emergency conditions. However, the cost of that care is only $49.99 for a video consult (see our pricing page for more info). Plus, no time was spent rearranging social, family, or work commitments, traveling, or sitting in a waiting room. According to that same national telemedicine service, a telemedicine visit costs only about $5 worth of your time compared to the $43 for an in-person visit.
Going back to the Colorado Health Access Survey, it would appear that by addressing the top four reasons why 40% of patients are visiting emergency rooms for non-emergency reasons would help decrease the burden on patients and emergency rooms.
Here at Care on Location (www.careonlocation.com), we address those reasons by:
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