If you need medical care quickly, who are you going call?
Not that long ago, you would probably have dialed 911 or led to the closest emergency room, particularly if it was following your regular physician’s business hours.
Today, based on the seriousness of your medical condition, you have other options aside from the ER, including an urgent care centre or a walk-in clinic.
Both forms of fast care are growing quickly. The number of urgent care centers rose from 6,400 in 2014 to 8,100 now, with this number increasing every year. Pharmacy- and retail-based practices have also been on the fast track for growth.
These alternatives reflect a significant development in how healthcare is delivered. But experts say it is important for consumers to understand when each is appropriate–and if it is not. When used correctly, these newer options can make it easier for you to find the care you want, when you want it–and save you time and money, too.
Here is what you want to know to make wise decisions for you and your loved ones.
What’s Behind the New Options?
Emergency room care is expensive. A 2016 study in the Annals of Emergency Medicine discovered that, even for individuals with the same diagnosis, therapy costs about 10 times more in the ER (an average of about $2,200) than at an urgent care centre (roughly $168).
Partly for this reason, some insurers now aggressively steer people away from the ER. Anthem, which insures some 40 million Americans, has advised its members in a number of studies, such as Georgia, Kentucky, Missouri, and Ohio that the company reserves the right to deny policy for ER visits that don’t meet its definition of a legitimate emergency.
Consumers have their own motives to avoid the ER. To begin with, more of these are now enrolled in high-deductible health insurance programs , which require individuals to pay thousands of dollars out of pocket before insurance kicks in. And insurers increasingly need hefty copays for ER care.
To make things worse, about two-thirds of ER physicians aren’t directly employed by the hospitals in which they operate, and can charge separately, according to the American College of Emergency Physicians. So, even if the ER is on your insurer’s network, you could still get stuck with a much greater than anticipated emergency room bill if it ends up that the doctor who treats you is from your network.
Insurers, however, typically do cover urgent care and walk in clinics, with copays very similar to what you would pay at your physician’s office. And even if you need to pay from your pocket, the price for services is a lot lower in these newer choices than they’re in the ER. Finally, they are usually conveniently situated, and have shorter wait times than ERs–all of which makes them appealing choices for when you require care fast but are not having a life threatening emergency.
It Pays to Plan Ahead
As urgent care centres and walk-in practices become more prevalent, consumers have a better knowledge of when they’re appropriate, says Laurel Stoimenoff, CEO of the Urgent Care Association of America in Warrenville, Ill.
“More people are using urgent care and know how we differ from ERs,” she says. “Consumers are figuring it out, and that is important financially and scientifically.” Just about 2 to 4% of individuals that come to an urgent care centre have to be taken to an ER, Stoimenoff states.
Ryan Stanton, M.D., a spokesperson for American College of Emergency Physicians and an ER physician in Lexington, Ky., agrees that walk-in clinics and urgent care facilities are great choices for countless patients with health issues that ought to be treated quickly but are not life-threatening emergencies.
And, he says, customers need to do some research beforehand, so that if they need care, they know where to go. “Every family ought to be aware of the facilities in their area and when to visit one versus another,” Stanton says.
A Quick Guide to Quick Care
Step one is to consult your regular physician’s office to determine whether they give walk-in or same-day visits. Some clinics now do that. And our medical experts say that it is ideal to get your attention from your primary-care supplier when possible, as that makes it easier to keep tabs on prescriptions and track chronic health problems you might hav.
But if you do not have a primary-care physician, or when your physician isn’t available or when you are traveling, here is what you will need to know about other alternatives for walk-in care, in addition to advice on when you should still visit the ER.
Walk-in Clinic
A clinic within a retail store with an onsite pharmacy; important players include CVS, Target, Walgreens, and Walmart. They do not require appointments and are often open on weekends and nights.
When to go: Walk-in practices are great for several common but not serious problems, such as bronchitis, ear infections, sore throats, urinary tract infections, rashes, minor sprains, and cuts that don’t require stitches. They are also able to provide some preventive care, like vaccinations, and may be able help you track certain chronic health issues, such as hypertension or diabetes, through screening tests. However, any chronic health problem ought to be modulated by a regular doctor.
Who works there: These practices are generally staffed chiefly by nurse practitioners, nurses who have advanced training and may prescribe medication. And because these facilities are often located in shops that also have pharmacies, you can often fill prescriptions at exactly the exact same time.
Price: Low, usually less than $100 if you’re paying out of pocket. In case you have insurance, including Medicare, you will probably have to cover just your copay (provided you have met your deductible), even though it’s better to check with your insurer about any restrictions.
Urgent Care Centres
Urgent care centers can manage all the very same issues as a retail practice, in addition to some which are more severe but not always severe enough to justify a visit to the ER (see below). Examples include cuts requiring stitches, a suspected fracture, or even a minor asthma attack.
Who works there: A doctor who specializes in emergency or family medication, also often a physician assistant or nurse practitioner, nurse, and radiologist. Urgent care centers often offer standard X-ray and lab services, including blood testing, though not more complex imaging tests such as MRIs or CT scans. In certain nations, employees there can also dispense needed medication.
Price: Moderate–usually less than $200 if you’re paying out of pocket. If you’re insured, such as on Medicare, you will typically have to pay only your copay (provided you have met your deductible), though check with your insurer for any restrictions.
Emergency Room
All ERs are open round the clock, treat patients by severity of maintenance (not when they arrived ), and are required by law to take care of everyone who comes in, irrespective of insurance or ability to pay.
When to go: The ER is where you need to go for issues that endanger”life and limb,” such as difficulty breathing, chest pain, seizures, head injury, vomiting blood, severe allergic reactions, loss of consciousness, badly broken bones, and profound or poorly bleeding cuts. They can also deal with a mental health or substance abuse crisis, particularly if accompanied by suicidal thoughts. It’s ideal to ascertain that ERs near your house accept your insurance before you have an emergency, and to map out the fastest route to this ER.
Who works there: Emergency-medicine doctors, nurses, physician assistants, and experts.
Price: High. In case you must pay out of pocket, it might cost you in the thousands: A 2016 research from Texas found that the normal ER trip cost $2,259 at hospital-based ERs and $2,199 in freestanding ones. If you’re insured, you will probably have a higher copay at the ER than you do in your physician’s office or in urgent care or walk-in clinic.
Tips to Deal with a Medical Emergency
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