Tampa Bay’s Freestanding Emergency Departments Raise Cost Concerns

TAMPA, Fla. — Freestanding emergency departments are becoming a familiar sight throughout the Tampa Bay area.

These facilities provide a way for patients to access emergency care conveniently without the need to go to a traditional hospital. However, many patients have reported to the Tampa Bay 28 I-Team that they weren’t fully aware of the financial implications when they sought treatment.

For example, one patient noted that his insurance was charged over $8,000 after he received care for a dislocated finger. Another individual’s visit for rabies vaccinations resulted in a staggering bill of $35,000. Yet another found themselves facing charges of more than $17,000 after a head injury.

“I think something’s really out of whack,” Abram Jacobson remarked. “I know I’m not the only one feeling this way, and it felt like such a minor issue.”

Growth of Freestanding Emergency Departments Across Florida

Data reviewed by the I-Team indicates that Florida has 166 off-campus emergency departments, which collectively saw close to two million visits.

Unlike urgent care facilities, freestanding emergency departments function like hospital emergency rooms and consequently charge emergency room rates. A Florida House analysis from 2021 unveiled that treatment at an urgent care center averaged around $193, compared to over $2,000 at freestanding emergency departments. Additionally, a separate study noted that the entry of each freestanding emergency center into a market was linked to an increase of about 3.6 percentage points in overall emergency department spending.

“The primary cost driver for every health plan in the country is the emergency room,” Bill Hennessey, a physician and patient billing advocate, asserted. For less severe cases where hospital admission isn’t anticipated, urgent care usually costs between $200 and $300. “It’s a chance to make money,” he said. “Just follow the money.”

Striking Costs for Simple Treatments

Mark Currier suffered a dislocated finger while playing basketball. “It was at a pretty extreme angle,” he recounted. Worried it might be broken, he quickly searched online and visited the nearest freestanding emergency department listed on his phone.

“They just pulled my finger straight, which wasn’t very pleasant, then put it in a splint and sent me on my way,” he reflected. But the bill shocked him. “The total charge sent to my insurance was over $8,000 for that,” he recalled, adding that he believed an urgent care center could have handled his injury just fine. “It wasn’t complicated at all,” he said, admitting he didn’t grasp the distinction between urgent care and a standalone emergency center at the time. “I just Googled it and picked the closest one.”

A Jaw-Dropping $35,000 After A Bat Incident

Abram Jacobson’s ordeal started when his dogs found a bat in the yard. Curious, he touched the bat to see if it was alive. Following advice from his veterinarian, who administered rabies vaccinations to his dogs costing $180, Jacobson was told to seek medical attention for himself and went to a nearby freestanding emergency department.

“I was in and out pretty quickly, like it was just a routine shot,” he noted. But when he received the bill, he was stunned. “Seeing they charged $35,000 for that was mind-boggling,” Jacobson expressed, adding that he didn’t receive all the shots he needed, forcing him to visit the health department later for additional boosters.

Over $17,000 for a Head Injury

Linene Kates experienced a serious fall while attending a boat show in Tampa when she tripped and hit her head hard. “I went headfirst into concrete,” she said, and chose a freestanding emergency department for what she thought would be faster treatment. Unfortunately, she ended up waiting for about nine hours.

No one checked on her during that time, and her son was continually asking for more ice packs as they melted away. After an MRI and receiving a head wrap, she was cleared to go home. The bill? It came to $17,437, which also included a charge from her treating physician.

New Patient Warning Requirements in Florida

Florida lawmakers are conscious that patients may confuse freestanding emergency departments with urgent care clinics. A law mandates these facilities to display signs that clarify the following:

• The facility operates as a hospital emergency department.
• It is not an urgent care center.
• Services are billed at emergency department rates.

They are also required to post their average facility fees, which can sometimes exceed $5,000.

Hospital Association Supports Freestanding ERs

Although the Florida Hospital Association declined to provide an interview to the I-Team, they countered the negative views regarding freestanding emergency departments. In their statement, they mentioned:

“As the demand for healthcare rises with the growth and aging of our population, timely access to care becomes essential. Immediate treatment can significantly improve health outcomes and save lives. Freestanding emergency departments play a crucial role in making emergency care more accessible, thus reducing patient wait times.”

Guidance for Seeking Medical Treatment

Hennessey suggests that anyone experiencing a potential stroke, heart attack, serious injury, or similar urgent condition should prioritize a visit to an emergency room affiliated with a hospital instead of an urgent care clinic. “I really want those who think they need emergency care to go to a hospital-connected ER. That way, if they require more specialized treatment, they are already in the right place,” he explained.

Understanding the distinction between less severe conditions that can be treated at urgent care and serious medical needs could help avoid surprising bills. Here’s a brief guide Hennessey shared with the I-Team:

Symptoms/Conditions for Urgent Care

• Persistent cough
• Sore throat
• Ear pain
• Asthma flare-up
• Eye issues (redness/discharge)
• Fever without rash
• Dehydration
• Abdominal pain
• Flu-like symptoms
• Suturing minor cuts
• Urinary issues
• Minor sprains/strains
• Vomiting
• Strep throat
• Sinus infection

Symptoms/Conditions for Emergency Room

• Chest pain
• Difficulty breathing
• Slurred speech
• Weakness on one side of the body
• Serious burns
• Fractures
• High fever with altered mental state
• Seizures
• Head injuries
• Suturing major wounds
• Severe allergic reactions
• Intense abdominal pain
• Severe bleeding
• High fever
• Vaginal bleeding during pregnancy