A new initiative is calling for establishing transparency in billing while encouraging efficient facility utilization, keeping unnecessary medical costs at bay.
“The goal of the ER Savings Initiative is to deliver care in a hybrid model that collaborates with health systems to eliminate the unnecessary use and costs of their ERs that can clog the system, which reduces their profit margin,” according to Azar Zaidi, vice president of strategy at Legacy ER & Urgent Care, creator of the Initiative.
Legacy ER & Urgent Care, a hybrid care facility offers ER and urgent care services under one roof, is gaining traction with payers, employers, and health care systems “simply because it provides parallel incentives for them as well,” Zaidi says. “At Legacy ER & Urgent Care, patients meet with board-certified and ER-licensed physicians who review their health issue and determine if they need to be treated as an ER patient or as an urgent care patient. Patients are billed accordingly, allowing them to only pay for the care they need.
Research conducted in preparation of the ER Savings Initiative showed staggering numbers on just how healthcare facilities overcharge—and patients overpay. The ER Savings Initiative employs a value-based healthcare mindset while revealing the true cost of visiting an emergency room versus visiting an urgent care facility. According to the Center for Medicare and Medicaid Services, the per capita expenditure for healthcare is approaching $10,000 each year.
Yet, the ER Savings Initiative shows that a large portion of those costs could be avoided if consumers are well informed, according to Zaidi.
“The ability to drive down unnecessary ER utilization and spending, while establishing an objective delivery model for right/appropriate use, is an outcome that all participants would like to achieve,” he continues. “It’s rare to find a for-profit, value based healthcare initiative that is a win/win for multiple parties.”
On the patient side, savings come from healthcare facilities charging fair amounts for care provided and patients making smart choices on exactly where to go for medical services, according to Zaidi.
“If a patient were to visit an ER for a simple case such as strep throat, they would be charged ER prices,” he says. “In reality, the patient only needed to visit their primary care physician or an urgent care center where it would not be treated as an emergency case, therefore the patient would not be charged for emergency services when it wasn’t truly necessary.”