The End of $1000+ Non-emergency ER Visits?


A few years ago I had a very strange medical situation. My face started to swell to unbelievable proportions, especially around my eye and forehead area. Thinking it was an allergic reaction of sorts, I took some over the counter antihistamines, put some ice on it, and rubbed a cream on the swollen area. Saturday afternoon, 12 hours, and a significant amount of Googling later, there was still no improvement, so I went to the emergency room at my local hospital.. I spent several hours waiting to see an ER physician, who also could not diagnose the cause of the swelling. (For those of you out there wondering, it was determined not to be any kind of food or plant allergy or insect sting, but that’s as far as we got.) I was given a prescription for a course of oral steroids for my mystery illness and sent on my way. I am not sure what my hospital bill was, but I do know that I had a co-pay of $150. I am willing to bet the actual bill was well over $1,000.

What excites me now about this experience are evolutions in the healthcare delivery model that mitigate the need for this kind of ER hospital visit (and expense) for non-emergencies. Today, if I were to experience the same kind of odd facial swelling, I could go to a number of new kinds of clinics where insurance is accepted, appointments aren’t necessary, and wait times are minimal. CVS has dozens of MinuteClinics, WalMart treats patients at clinics in 27 states, and Walgreen’s is expanding into the market with its TakeCare Clinics. All of these models expand healthcare options for patients that may not need an ER visit but who have had no alternative options in the past.

Perhaps the most surprising model I’ve come across is QuadMed, an employee funded on-site health clinic. They also happen to be a GE Healthcare EMR customer. In this case, employers sponsor on-site clinics, which may help reduce overall healthcare costs to the employer. QuadMed then takes care of staffing and managing primary care for employees, retirees and their dependents at the on-site health clinic. Personally, I think being able to take care of basic medical issues while I’m at work would save my employer on not only the expense of healthcare, but also on my productivity – walking somewhere in the building to get seen is much more efficient for me than driving across town and waiting to see a provider!

Some of my new favorite healthcare delivery models are @jayparkinson’s take on patient management with his startups Hello Health and Sherpaa, I’m also a fan of companies like Vidyo, who are enabling doctors to connect with patients through video, ushering in exciting advancements in telemedicine. As the U.S. healthcare system evolves, I’m interested to see how the delivery of care continues to change. And in case you wanted to know, yes, the steroids took care of my swollen face. I’m happy to report that everything was back to normal in just a few hours!



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