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Average Cost for People with Hospital ER Visit, MEPS

Find out the average cost for people with hospital ER visits. Average expenses for people who had one or more visits to the Emergency Room (ER) were $1,533 in 2014, up 7.7% from 2013 according to the Medical Expenditure Panel Survey (MEPS). Median, or typical, cost was $749. For people ages 45 to 64, the cost was substantially higher on average ($2,176, up 18%). Uninsured people under age 65 averaged $1,251 in expenses ($585 median), of which they paid more than 1/3 out of pocket. While average cost for those age 65 and up was generally $1,300-1,400, Medicare recipients paid only 3 to 6% out of pocket. Median charges for children under age 18 were $449 to $544. In a separate report (not shown), the average expenditure per Emergency Room visit for 2017 was reported at $1,482, with a median cost of $776. Many ER users end up having more than one trip to the Emergency department, so the expenses can add up in a year. The federal government has not prepared a detailed report for the 2018 or 2019 data, yet. It may have discontinued detailed explanations, in favor of the online interactive tool – which we think would be very unfortunate.

Emergency Medical Services (MedlinePlus)

Emergency Medical Services page at MedlinePlus includes multiple reports by the American College of Emergency Physicians, on topics such as Emergency Room (ER) costs, tips for seniors, children and when to use the emergency department

Emergency Room or Urgent Care?

Should you go to the Emergency Room (ER), or to an urgent care center? Useful overview, by a private for-profit company solvhealth.com

Pediatric Emergency Care Guidelines (2009)

The American Academy of Pediatrics published guidelines in 2009 for for treating children in the Emergency Department. Guidelines pertain to medical and nursing leadership, equipment, medications and protocols. Collaborative effort with other professional associations, 2009, and reaffirmed April 2013. Free full text

Trauma Programs: Verified Trauma Centers (ACS)

Find hospital trauma programs that are Verified Trauma Centers by ACS. Level I, II and III Trauma Centers are listed here, by state (and other international locations), at the American College of Surgeons’ (ACS) website. Trauma Center designation is a voluntary process that hospitals may choose to pursue for Adult and/or Pediatric care. Level I is the highest level of five levels. A description of what’s expected to be available at each level can be found at amtrauma.org.

Truth about ER Visits: 2016 Data from CDC

CDC’s 2016 National Hospital Ambulatory Medical Care Survey reveals the median waiting time to see a physician or other provider in the Emergency Dept. was 17 minutes (see Table 4), a minute shorter than the previous year. Most patients (56%) spent between one and four hours in the Emergency Room (ER). About 58% arrived outside of the M-F 8a to 5p hours. More than half (57%) of ER patients were triaged as semiurgent or urgent when they arrived. (However, when billed at discharge or admitted to the hospital, the overwhelming majority of ER visits are likely to be billed as at least a moderate to high severity. Data not shown in this report.) Percent admitted or transferred to another hospital (including observation stays): 13.5%. Main reasons for an ER visit: stomach and abdominal pain, cramps or spasms; chest pain and fever. Cough and headaches also were common. Of the 45 million injury-related (or poisoning or adverse effects) visits, 23% were for falls – 2.8 times the rate of motor vehicle traffic-related injuries seen in Emergency Rooms. 2017 and 2018 ER information not yet available. Click on NHAMCS Emergency Department Summary Tables

Urgent Care – When Should I Go?

Example of a health system’s suggestion for using a clinic Urgent Care setting vs. a hospital Emergency Room. Example is from Scripps in California

Other Helpful Listings

Accredited Healthcare Facilities – Joint Commission Accreditation (all states) Editor's Pick

The Joint Commission (formerly JCAHO – Joint Commission on Accreditation of Healthcare Organizations) accredits hospitals and other healthcare organizations. Quality Check provides accreditation and comparison information for hospitals, behavioral health care, home health/hospice, laboratories, some nursing homes (called nursing care centers) & assisted living centers, and other health care services. A few actual scores for acute care hospitals  and behavioral health (mental health) programs may be available for 2018.  For nursing homes, consumers are advised also to check state inspection reports . We recently discovered a 1-star Florida nursing home (the lowest possible rating in the state) had been accredited by the Joint Commission. Consumers are always advised to check multiple sources and ratings when researching quality of care. Conflicts in scores may suggest quality is not consistent.

Air Ambulance – Air Medical Base Locations by State

Find air ambulance and air medical base locations by state. The Atlas and Database of Air Medical Services (ADAMS) lists over 300 air medical service providers, types and number of aircraft, geographic coverage. Both rotor wing and fixed wing aircraft. Supported by the Association of Air Medical Services (AAMS). No utilization data. The most common names are Air Methods, CA Highway Patrol, Life Flight, LifeNet, Mercy and PHI Air Medical. Includes US Coast Guard Air Stations in Kodiak and Sitka Alaska. Updated 2019

All-Terrain Vehicle (ATV) Injuries, 2017 (pdf)

The Consumer Product Safety Commission has issued its annual report of injuries and deaths from ATVs. Injuries brought 93,800 people to the ER in 2017, with 26% of them (24,000 kids) under age 16. Injuries have declined by more than 1/3 since 2007. In 2016 there were an estimated 531 ATV deaths, but reporting is preliminary and still ongoing. Report released February 2019

Arkansas Hospital Volumes, Prices, Quality Ratings – by name of hospital

Arkansas hospital volumes, prices, quality ratings and patient satisfaction are listed by name of hospital. Find average charges (a proxy for average costs) for 40 common hospitalizations at specific AR hospitals by Clicking on INPATIENT PRICING after you’ve selected your hospital. Price List varies by hospital, but may include maternity and childbirth, stroke, chest pain, stomach disorders, back pain, nutritional problems (diabetes), blood infection (septicemia), rehabilitation, heart attack, cardiac cath, drug coated stent, congestive heart failure, kidney failure, urinary infection, COPD, pneumonia, total hip or knee replacement surgery, hysterectomy, psychiatric care, ventilator support and more. Volumes are listed under the hospital’s Profile. To find quality scores on emergency department, heart attack, heart failure, pneumonia, COPD, stroke, delivery or surgical infections, and patient opinions, click on QUALITY at each hospital’s page. Hospital Consumer Assist is provided by the Arkansas Hospital Association. Prices from 2017; Quality and Patient Satisfaction scores reflect 2018 ratings

Emergency Dept. Report – Florida 2017 prices (pdf)

Find average prices for an Emergency Department visit in Florida in this report. Summary report shows average cost (charges) in 2017 for a hospital ER visit based on acuity. Low acuity Pediatric visit was about $1,050 in 2017; high acuity pediatric ER visit was $3,420. For adult women, the low acuity mean charge was $1,456; High acuity average 2017 charge for men was $7,824. Common symptoms (e.g. $10,442 adults for abdominal pain visit to the ER; $5,722 for back pain; $5,189 for a sprain; $3,241 for upper respiratory infection visit; $4,962 for adult pregnancy complication, adult urinary tract infection averaged $7,411 and more.) Average cost increased with age. Average pediatric visit for upper respiratory infection was close to $2,000. See Tables 4 and 5 for average prices for an emergency visit and Insurance status or Self-Pay charges. Self-pay uninsured average charge was $1,135 for a low acuity visit, to $6,417 for high acuity. 29 pages, published by FL Agency for Health Care Admin. June 2018. No updates as of early 2020.

Florida ER Visit Charges, 2018

Florida ER visit charges for each hospital in 2018. Find the average cost of an emergency room (ER / ED) visit at each Florida hospital in 2018. State average ER visit cost (charge) was $6,609 (about $60 Billion for over 9 million ED visits). Average cost was up about 7.7% from 2017. Fawcett Memorial Hospital in Port Charlotte had the highest average charge in FL at a whopping $15,360 per ER visit in 2018. Three additional hospitals had average charges over $14,000: Mercy Hospital a campus of Plantation General Hospital, North Florida Regional Medical Center in Gainesville, and Regional Medical Center Bayonet Point. Only 1 hospital (Regional General Hospital Williston) had an average charge of $1,000 or less, same as last year. Number of ER patient visits are shown here. The highest volume Emergency Department was Lakeland Regional Medical Center, with nearly 169,000 visits. Its average price was $6,993.  Complexity and seriousness of the visit vary from hospital to hospital. Easy to use tool, but not severity-adjusted. Average charges for broad diagnostic groups can be found, by using the filters in the search tool. From FloridaHealthFinder.gov.  Check our listing for Hospital Compare to see each hospital’s most recent star ratings and performance on emergency care.

Georgia Health Insurance Plan Ratings and Comparisons 2019

Find Georgia health insurance plan ratings and comparisons for 2019. Scroll to the bottom to find External Quality Review Organization (EQRO) which lets consumers read about performance of health plans in GA.  Large report using HEDIS measures. Compare quality ratings and member satisfaction scores for Medicaid, Amerigroup Community Care (Anthem), CareSource, Peach State Health Plan, WellCare of Georgia and The Georgia Families Amerigroup 360. Covers access to care, cancer screening, immunizations, dental visits, opioids at high dosage, ER visits, diabetes care, prenatal care, 7-day followup after mental health admission, member satisfaction (CAHPS) and more using 2018 performance scores. Other reports are at this website that may have more information. Released in April 2019 by Georgia Dept. of Community Health at dch.georgia.gov

How Much Does an Office Visit cost compared to an ER visit?

An average physician office visit in 2008 cost $199, compared to $922 for an Emergency Room visit (median was $89 for doctor’s visit, vs. $422 for ER). Top 5 conditions shown for each ambulatory care visit type. Consumers should expect considerably higher prices since 2008; $922 in 2008 is about $1244 in 2019 using medical inflation factors. However, this report informs consumers about the drastic difference between price of care in a doctor’s office vs. Emergency Dept. MEPS data published in Statistical Brief #318, March 2011

Louisiana Hospital Ratings and Prices – LA Hospital Inform

Find range of charges (low price and high price) for Medicare patients at Louisiana hospitals, both inpatient and outpatient. Hospital-specific inpatient charges do not include childbirth or C-section, since it’s Medicare only. Find hip or knee surgery prices, gall bladder removal, psychiatric admission, rehab, heart problems, stent, stomach problems, stroke, GI hemorrhage, kidney failure, COPD, pneumonia, diabetes, bowel surgery, more; outpatient Medicare prices include ER visits, heart tests such as cardiac cath, EKG, heart imaging, valve repair; CAT scan or CT angiography, GI endoscopy, more. Quality scores and volumes (which cover all patients), are similar to those at HospitalCompare, but may be less current (2017). LA Hospital Inform is sponsored by the Louisiana Hospital Association; Price ranges from 2017 (outpatient and inpatient)

Massachusetts Hospital Staffing Plans 2019

Massachusetts Hospital Association website presents each hospital’s unit-by-unit staffing plans budgeted for 2019, by shift, and actual staffing for fiscal year 2018 (and prior years). First in the country to voluntarily post nurse-to-patient staffing ratios. May be difficult for consumers to interpret to compare MA hospital performance, especially with all the different types of inpatient units. However, the Emergency Department information also includes specialties such as Chest Pain Center and Stroke Center, and average daily number of ER visits. Massachusetts PatientCareLink; click on Staffing Plans

Nevada Hospital Ratings and Patient Satisfaction Scores

Nevada Hospital Association shows NV hospital performance ratings on Emergency care, Heart care, pneumonia, stroke, COPD, hip and knee, infections, plus patient opinion ratings. Shows 2016-2017 data (some data older, to 2015). Some measures may be the same as at CMS HospitalCompare website, but dates may vary. Scores also for adverse events, surgical complications, mortality, readmissions. Consumers may view 3 or more hospitals side-by-side. Volume levels for certain procedures are given, but questionably labeled to read that lower volume is better.

New Hampshire Physician Visit, Outpatient Hospital and Dental Prices – Compare (free)

Compare physician office visit prices, dental prices, hospital outpatient tests, PT visits and some surgery prices, as well as some ER prices (estimated at 2017-2018 prices plus 5% inflation) in NH. Choose procedure or test (e.g. lab, Radiology such as x-ray, MRI, CT or ultrasound). Select insurance, or uninsured to compare charges with your deductible. Tonsillectomy, colonoscopy and about 20 different surgeries are in Outpatient, which are bundled to include surgeon and anesthesia costs. Price transparency project developed by the New Hampshire Insurance dept. Excellent website, easy to navigate

Texas – Guide to Texas HMO Quality 2018-2019 (OPIC)

The Guide to Texas HMO Quality 2018-2019 shows detailed clinical quality comparisons of HMO health insurance plans.  Compare HMOs Aetna, Christus, Cigna, Community First, FIRSTCARE, HMO Blue Texas, Humana, Memorial Hermann, Scott and White and United Healthcare of Texas. Indicators include asthma, childhood immunizations, cancer screening, heart care, high blood pressure, diabetes care, prenatal care, mental health care, flu shots, antibiotic utilization rates, rates of physician board certification, and more. Lengthy (211 pages) but valuable report. Pub. by TX Office of Public Insurance Council

Virginia Healthcare Prices – Ambulatory Surgery, Tests, Hospital Stays

Virginia Healthcare Prices shows average price ALLOWED (commercial insurance prices) in 2017 for almost 40 common healthcare services in VA. Includes a mix of outpatient, clinic, hospital stays and other services such as an ambulance (average $522) or helicopter ride (almost $17,000). Examples: hospitalizations (maternity), outpatient xray/imaging, CT and MRI tests; colonoscopy, mammogram; inpatient or ambulatory surgery (e.g. hernia, gall bladder, knee replacement, tonsillectomy, kidney stones); and ER or office visits. Shows median and range of costs and provides a breakout by type of cost: facility, surgeon, anesthesiologist, etc. Also shows average price by setting: clinic vs. hospital vs. ambulatory surgical center; and region of Virgina. Median physician office visit cost was $77.  The 2019 report shows the average allowed amount for each service that you or your insurance plan ACTUALLY PAID in 2017. More relevant than most pricing information, but lags in timeliness. Add at least 4.1% medical inflation rate to estimate 2019 costs. Virginia Healthcare Pricing Transparency, from Virginia Health Information (VHI), updated May 2019

Wisconsin ER and Hospital Urgent Care Prices (Emergency Department) Editor's Pick

Find ER visit and urgent care prices for common visits to WI emergency departments (ER) or hospital-based urgent care. Examples of typical charges: mood disorders, urinary tract infection (UTI), nausea and vomiting or teeth problems. Shows median (middle) price for ER (2018-2019) WITHOUT the physician’s fee, and how many cases the hospital treated. If the hospital has on-site urgent care, it will show that price also. Example: Mercy Health Hospital in Janesville charged $2,102 (median charge during April 2018 to March 2019) in the ER for urinary tract infection (UTI), but just $345 in its urgent care service. Free-standing community Urgent Care clinics are not included in these prices.  Wisconsin Hospital Association’s PricePoint makes comparing hospital prices possible. Compare hospitals downtown vs. those in the suburbs.

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